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Raloxifene and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women [TA161]

Measuring the use of this guidance

Recommendation: 1.1

Alendronate is recommended as a treatment option for the secondary prevention of osteoporotic fragility fractures in postmenopausal women who are confirmed to have osteoporosis (that is, a T-score of −2.5 SD or below). In women aged 75 years or older, a DXA scan may not be required if the responsible clinician considers it to be clinically inappropriate or unfeasible. When the decision has been made to initiate treatment with alendronate, the preparation prescribed should be chosen on the basis of the lowest acquisition cost available.

What was measured: Proportion of patients aged 75 or over with a record of a fragility fracture on or after 1 April 2014 and a diagnosis of osteoporosis, who are currently treated with an appropriate bone-sparing agent.
Data collection end: March 2015
79.3%
Area covered: England
Source: Health and Social Care Information Centre. Quality Outcomes Framework.

What was measured: Proportion of patients aged 50 or over and who have not attained the age of 75, with a fragility fracture on or after 1 April 2012, in whom osteoporosis is confirmed on DXA scan, who are currently treated with an appropriate bone-sparing agent.
Data collection end: March 2015
82.8%
Area covered: England
Source: Health and Social Care Information Centre. Quality Outcomes Framework.


Recommendation: 1.4

Teriparatide is recommended as an alternative treatment option for the secondary prevention of osteoporotic fragility fractures in postmenopausal women: • who are unable to take alendronate and either risedronate or etidronate, or have a contraindication to or are intolerant of alendronate and either risedronate or etidronate (as defined in section 1.6), or who have a contraindication to, or are intolerant of strontium ranelate (as defined in section 1.7), or who have had an unsatisfactory response (as defined in section 1.8) to treatment with alendronate, risedronate or etidronate and • who are 65 years or older and have a T-score of –4.0 SD or below, or a T-score of –3.5 SD or below plus more than two fractures, or who are aged 55–64 years and have a T-score of –4 SD or below plus more than two fractures.

What was measured: The proportion of fracture liaison services in England and Wales that were able to recommend the initiation of teriparatide.
Data collection end: December 2014
31%
Area covered: England
Source: Royal College of Physicians. Fracture Liaison Service Database (FLS-DB) Facilities audit



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