E054 Routine osteoporosis care in UK primary care settings: a national e-survey

Hawarden, Ashley; Cox, Natasha; Bullock, Laurna; Protheroe, Jo; Jinks, Clare; Paskins, Zoe

Abstract

Background/Aims Osteoporosis care is primarily delivered in primary care settings, but little is known about routine practice and implementation of evidence-based care in the UK. This e-survey aimed to examine current practice and perceptions of osteoporosis care among UK primary care professionals. Methods Primary care staff were invited via research networks and social media to complete a national e-survey. The e-survey, informed by national guidelines, literature, public contributors, and a community of practice, explored participants’ experiences, confidence, roles, and challenges in osteoporosis care. Fixed response data were analysed using descriptive statistics (StataMP) and a reflexive thematic analysis of free text comments was conducted. Results The e-survey remained open for a period of ten weeks during 2023, and 341 responses were obtained from 309 healthcare professionals (HCPs) and 32 non-healthcare professionals (nHCPs). Most respondents were General Practitioners (GPs) (n = 198, 58.06%). Osteoporosis care was primarily delivered by GPs, pharmacists, and advanced nurse practitioners. The majority of responding HCPs agreed that they were worried about osteoporosis medicines causing unpleasant (n = 228, 73.79%) and long term (n = 204, 66.45%) side effects. More than half of responding HCPs did not agree that they were confident to interpret the numeric results of bone density scans (n = 158, 52.32%) or to make recommendations about treatment breaks (n = 194, 64.24%). Pharmacists reported being more confident in osteoporosis medication management than other HCPs. Fracture risk assessments were performed by 229 HCPs, most using FRAX® (n = 226, 98.69%). Fracture risk was proportionally more likely to be calculated for people with a history of fragility fracture when compared to those taking steroids or with a history of falls. Most prescribing HCPs (n = 247) followed NICE guidance (n = 160, 64.78%) and frequently prescribed oral bisphosphonates and hormone replacement therapy. Over one third of responding HCPs (n = 98, 39.68%) reported not routinely providing, or directing to, patient information about osteoporosis medicines and 116 (48.86%) reported not routinely organising medication reviews. When arranged, medication reviews were most reported to be generic rather than osteoporosis specific. Bone density scans were typically completed within 12 weeks of referral (72.77%), and most reports included management advice (72.77%). During medication reviews (n = 176), HCPs frequently discussed adherence (n = 166, 94.32%) and side effects (n = 165, 93.75%) but less often asked about height loss (n = 51, 28.98%) or back pain (n = 77, 43.75%). Reflexive thematic analysis of free-text comments identified four overarching themes: challenging decision-making processes, discontent with secondary care responsibilities, balancing competing priorities and inadequate access to resources. Conclusion To our knowledge, this is the first national e-survey on routine osteoporosis care in UK primary care. An ongoing qualitative study will further explore these findings, aiming to develop resources that support evidence-based osteoporosis management. Disclosure A. Hawarden: None. N. Cox: None. L. Bullock: None. J. Protheroe: None. C. Jinks: None. Z. Paskins: Other; Keele University has received sponsorship from UCB Pharma Limited.

Citation

Hawarden, A., Cox, N., Bullock, L., Protheroe, J., Jinks, C., & Paskins, Z. (2025, April). E054 Routine osteoporosis care in UK primary care settings: a national e-survey. Poster presented at British Society for Rheumatology Annual Conference 2025, Manchester Central Convention Complex, Manchester, England, UK

• Presentation Conference Type: Poster
• Conference Name: British Society for Rheumatology Annual Conference 2025
• Start Date: Apr 28, 2025
• End Date: Apr 30, 2025
• Acceptance Date: Apr 28, 2025
• Online Publication Date: Apr 28, 2025
• Publication Date: Apr 28, 2025
• Deposit Date: Jun 6, 2025
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: Supplement_3
• DOI: https://doi.org/10.1093/rheumatology/keaf142.290
• Public URL: https://keele-repository.worktribe.com/output/1242704
• Publisher URL: https://academic.oup.com/rheumatology/article/64/Supplement_3/keaf142.290/8115250