Osteoporotic fractures audit

The effectiveness of strategies for the Secondary Prevention of Osteoporotic Fractures

This project started in June 2001 and finished in May 2004.

The project grant-holder was Dr Alastair R McLellan, Consultant Physician, Western Infirmary, Glasgow.

The aims of this project were to determine:

  1. The current provision of osteoporosis services in Scotland in secondary and primary care and how they function with regard to:
    • interaction with orthopaedic and A&E fracture services
    • case finding of fracture cases
    • provision of assessment for osteoporosis, and
    • how they effect changes in therapy.
  2. The effectiveness of current services in targeting patients presenting with fractures (of hip, spine and forearm) and in delivering strategies (either investigation such as DXA scanning or prescription of antiresorptive treatment) for the secondary prevention of osteoporotic fractures in the presence and absence of osteoporosis services.
  3. Barriers that prevent assessment or treatment of patients for the secondary prevention of osteoporotic fractures.
  4. The costs of providing appropriate services for assessment for the secondary prevention of fractures.


  • Copies of the report have been distributed to key individuals within NHSScotland.
  • Preliminary data were presented at the Ninth Bath Conference on Osteoporosis (June 2003).
  • The complete data were presented at the October 2004 SIGN guideline implementation meeting.
  • Two abstracts summarising key final outcomes were presented at the Tenth National Osteoporosis Society Conference on Osteoporosis, Harrogate (November/December 2004).
  • Two articles for submission to peer reviewed journals are in preparation.

Future of the Work

The report recommends that a further audit should be commissioned following the introduction of further fracture liaison services to determine the relative rates of fractures in centres where patients over the age of 50 with fractures have only recently been identified and treated compared to the established centres.

The report also recommends research into the most effective methods of vertebral fracture identification to enable therapeutic intervention and a reduction of future morbidity and excess mortality.

Published Date: 19 October 2005