ArticleArchives of osteoporosis2023
Current approaches to secondary prevention after hip fracture in England and Wales - an analysis of trends between 2016 and 2020 using the National Hip Fracture Database (NHFD).
Article in Archives of osteoporosis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Impact of a national reimbursement policy for secondary fracture prevention on early secondary fractures after hip fracture surgery in Japan: a nationwide interrupted time series analysis.Archives of osteoporosis · 2026Article
- Underuse of osteoporosis treatments before and after hip fracture: longitudinal findings from the Gruppo Italiano di Ortogeriatria (GIOG 2.0) study.Frontiers in aging · 2026Article
- WHO benchmarks for equitable hip-fracture care and osteoporosis treatment in older people.Nature reviews. Rheumatology · 2026Review
- Review
- Biomechanical comparison of the therapeutic effect of a novel proximal femoral bionic intramedullary nail and traditional inverted triangle hollow screw on femoral neck fracture.Journal of orthopaedic surgery and research · 2024Article
- The Dutch multidisciplinary guideline osteoporosis and fracture prevention, taking a local guideline to the international arena.Archives of osteoporosis · 2024Article
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Authors and funding
3 authors.
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Abstract
Hip fractures are strong risk factors for further fractures. However, using the National Hip Fracture Database, we observed that in England and Wales, 64% of patients admitted on oral bisphosphonates were discharged on the same and injectable drug use varies from 0-67% and 0.2%-83.6% were deemed "inappropriate" for bone protection. This variability requires further investigation.
introductionA key aim for the National Hip Fracture Database (NHFD) is to encourage secondary fracture prevention of the 75,000 patients who break their hip annually in the UK, through bone health assessment and appropriate provision of anti-osteoporosis medication (AOM). We set out to describe trends in anti-osteoporosis medication prescription and examine the types of oral and injectable AOMs being prescribed both before and after a hip fracture.
methodsWe used data freely available from the NHFD www.nhfd.co.uk to analyse trends in oral and injectable AOM prescription across a quarter of a million patients presenting between 2016 and 2020, and more detailed information on the individual type of AOM prescribed for 63,705 patients from 171 hospitals in England and Wales who presented in 2020.
resultsMost patients (88.3%) are not taking any AOM when they present with a hip fracture. Half of all patients (50.8%) were prescribed AOM treatment by the time of discharge, but the proportion deemed 'inappropriate for AOM' varied hugely (0.2-83.6%) in different hospitals. Nearly two-thirds (64.2%) of those previously taking an oral bisphosphonate were simply discharged on the same type of medication. The total number of patients discharged on oral medication fell by over a quarter in these five years. The number discharged on injectables increased by nearly three-quarters to 14.2% over the same period, but remains hugely variable across the country, with rates ranging from 0-67% across different units.
conclusionA recent hip fracture is a strong risk factor for future fractures. The huge variability in approaches, and in particular the use of injectables, in different trauma units across England and Wales requires further investigation.
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