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Title: A Randomised Controlled Trial of Screening in the Community to Reduce Fractures in Older Women: The SCOOP Study
Authors: Holland, Richard
First Published: 2018
Publisher: Elsevier
Citation: Lancet, 2018, in press
Abstract: Background- Despite effective assessment tools and medications targeting osteoporosis and related fractures, screening for fracture risk is not currently advocated in the UK. We tested whether a community based screening intervention could reduce fractures in older women. Methods- We conducted a two-arm randomised controlled trial in women aged 70 to 85 years comparing a screening programme using the FRAX risk assessment tool versus usual management. The primary outcome was the proportion of individuals experiencing one or more osteoporosis-related fractures over a five-year period. In the screening arm, treatment was recommended in women identified to be at high risk of hip fracture, according to the FRAX 10-year hip fracture probability. Findings- 12 483 eligible women, identified from primary care, participated in the trial. Of 6 233 randomised to screening, treatment was recommended in 898 (14·4%). Osteoporosis medication use was higher at the end of year one in the screening group compared to controls (15·3% vs 4·5%, respectively), with uptake particularly higher (78.3% at 6 months) in the screening high risk subgroup. Screening did not reduce the incidence of all osteoporosis-related fractures (hazard ratio: 0·94, p=0·178, 95% C.I. : 0·85 to 1·03) but there was strong evidence for a reduction in hip fractures, a pre-specified secondary outcome (hazard ratio : 0·72, p=0·002 95% C.I. : 0·59 to 0·89). There was no evidence of differences in mortality, anxiety levels or quality of life. Interpretation- A systematic, community-based screening programme of fracture risk in older women in the UK is feasible. Whilst there was no reduction in overall fracture rate the intervention was effective in reducing hip fractures by an estimated 28%. Funding- The Arthritis Research United Kingdom (ARUK), formerly the Arthritis Research Campaign (ARC), and the Medical Research Council (MRC) of the UK jointly funded this trial.
ISSN: 0140-6736
eISSN: 1474-547X
Links: TBC
Embargo on file until: 1-Jan-10000
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Description: The file associated with this record is under embargo until publication, in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.
Appears in Collections:Published Articles, College of Medicine, Biological Sciences and Psychology

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