Osteoporosis in older women
Research type
Research Study
Full title
A qualitative exploration of older women and healthcare professional experiences to guide improvements in osteoporosis care
IRAS ID
326908
Contact name
Anne Heaven
Contact email
Sponsor organisation
Bradford Teaching Hospitals NHS Foundation Trust
Clinicaltrials.gov Identifier
55650, CPMS ID
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
We aim to improve primary-care for older women with osteoporosis.
Older women we spoke with previously felt unseen, unimportant, unheard and uninformed. These women felt that bone/joint health was an important issue for women aged 70+. Osteoporosis is a disease that makes bones more breakable and can lead to significant pain, disability and death, costing approximately £4.4 billion a year in the UK. Women are four times more likely to have osteoporosis than men and suffer fractures earlier. Osteoporosis care is poor in primary care even though good guidelines are available.
We will work with older women and healthcare professionals to help guide our research. We have already looked at published research and will build on this. We will identify what is important for both older women and professionals to inform our first interview questions. We will ask older women and healthcare professionals about the diagnosis and treatment of osteoporosis. We will also ask them how they manage osteoporosis as a patient or care provider. At regular intervals, research staff will look at the interview findings first and then share their thoughts with older women and professionals. Together we will explore what the interviews mean. These discussions may change the questions we ask and who we interview next.
We will combine all the information from interviews to identify what works well and less well in osteoporosis care. We will check these findings against the guidelines. We will continue to work with older women and healthcare professionals to develop recommendations for improving care. We will also identify areas of further work.
We will share our recommendations with healthcare commissioners and produce a summary for a variety of professional networks. We will publish papers in journals aimed at healthcare professionals and produce a summary document and advice for older women to use.
Lay summary of study results:
Healthcare professionals acknowledged osteoporosis as clinically important. But they described limited knowledge of prescribing, diagnostics, and management. Unlike other long-term conditions, osteoporosis guidelines were applied inconsistently. Follow-up varied due to a lack of standard care pathways, or funding for monitoring. Medication and bone density reviews were inefficient.Older women viewed symptoms of osteoporosis as part of 'normal' ageing. This delayed investigations or treatment. Most were unclear about their diagnosis, prognosis, or treatment plans. Self-management was not well supported. Information was often generic or absent. South Asian older women faced additional cultural, linguistic, and logistical barriers. They often relied on family and community networks.
There was little routine engagement with the wider primary care team. Allied healthcare professionals were an underused resource. Digital communication was common which further limited older women's engagement, or re-engagement. Despite these challenges, older women were willing to self-manage their condition. To do this, they wanted accessible, reliable information and empathetic support.
Conclusions
Osteoporosis remains poorly understood and managed, particularly in older women. Many older women accept care gaps. This is due to limited awareness and lack of meaningful engagement with healthcare professionals. Women aged 70+ face particular barriers. These include having more than one health condition, and low self-belief. They are also more likely to be digital excluded. Cultural and communication differences shape the care experiences of South Asian older women. Improved care navigation and greater involvement of the wider primary care team could help with engagement. This would support better self-management.
REC name
London - Bromley Research Ethics Committee
REC reference
24/PR/0500
Date of REC Opinion
21 May 2024
REC opinion
Further Information Favourable Opinion