Related Projects

A number of linked projects are using or supporting further development of the iFraP resources

iFraP-2: Increasing accessibility, applicability, and impact

The iFraP-2 project builds on the iFraP programme of work that has developed and tested a suite of resources that supports patient-clinician discussions about osteoporosis, fracture risk and treatment options.

iFraP-2 aims to develop and adapt the iFraP resources (clinical decision support tool, clinician training and additional resources) to increase their accessibility, applicability and impact:

To enable more clinical and patient end-users to use and benefit from the tool, outside the Fracture Liaison Service specialist clinical context
To enable more equitable access for people where English is not their first language or have other communication barriers

The resources will be adapted to be used in a primary care context with two additional versions of the clinical decision support tools being developed:

A standalone clinical support tool for health professionals with more information to guide non-specialists e.g. GPs, practice-based pharmacists
A standalone patient information resource that can be accessed by patients/members of the public

Through stakeholder engagement, we will determine the clinical decision-making and communication needs of non-specialist health professionals. This will support the development of the clinical decision support tool and identify amendments required to the existing iFraP clinician training.

The project will also include patient and public involvement (PPI) from the Keele Research User Group (RUG) to help shape the self-directed patient tool and community engagement with ‘Seldom Heard Voices’ to determine cultural acceptability of the tool and any adaptations needed. Finally, the patient directed tool will be translated into Urdu, as the second most common language in older populations after English.

The 12-month project started in March 2024 is sponsored by UCB Pharma.

PHORM: A person-centred primary care pharmacist-led osteoporosis review for optimising medicine

The PHORM study aims to investigate how practice-based pharmacists could deliver osteoporosis reviews in primary care, using interviews and workshops.

Interviews with a wide range of health professionals across primary and secondary care have explored the role of practice-based pharmacists, their perceptions of a new osteoporosis review and their training needs. This study is funded by the Royal Osteoporosis Society

These insights have informed the iFraP 2 study above.

More information: A person-centred primary care pharmacist-led osteoporosis review for optimising medicines (PHORM): a protocol for the development and co-design of a model consultation intervention | BMJ Open

INDEX: Improving understanding of bone density (DXA) scans

The INDEX study aims to explore how to optimise patient and clinician understanding of dual-energy X-ray absorptiometry (bone density – DXA) scans.

Research has shown that patients have confusions about DXA scans and results, including the purpose of DXA scans, ‘what they show’ and what numeric results mean. These uncertainties can affect commitment to osteoporosis treatment and clinical decision-making about osteoporosis medicines, contributing to the osteoporosis ‘treatment gap’. This research will help us to explore and enhance understanding of DXA scans and results by providing recommendations and a toolkit of resources. INDEX includes an interview study and consensus study to get agreement on recommendations for change.

Links to iFraP: the iFraP decision tool includes visuals to help people understand their bone density and fracture risk results. iFraP tools will be part of a new toolkit to help people understand their DXA results.

More information: https://sapc.ac.uk/conference/2024/abstract/how-can-patient-and-primary-care-professional-understanding-of-bone-density

Investigating the osteoporosis care gap in primary care

This Versus Arthritis funded PhD study is being undertaken by Dr Ashley Hawarden. Ashley aims to understand current practice of identifying, investigating, and managing osteoporosis in primary care. This research will also explore barriers towards providing osteoporosis care, and how they can be overcome.

This study involves a scoping review of xxxx, a large UK wide survey of osteoporosis primary care provision (n=342), in depth qualitative interviews and knowledge mobilisation activities.

iFraP resource adaptation (iFraP-2) will be informed by findings.

More information:

Understanding and improving osteoporosis diagnosis and treatment in primary care

DOMINO: Optimising osteoporosis medicine use for people with dementia

The DOMINO study forms the basis of an NIHR Advanced Fellowship for Dr Laurna Bullock. Laurna is exploring the optimal approach to managing osteoporosis for people with dementia or cognitive impairment. As part of this study Laurna will be exploring, if and how, iFraP resources might need adaption for people with dementia or cognitive impairment.