Background

The Women’s Health Strategy for England highlights the lack of focus on older women’s needs and experiences. We talked to 32 older women across five public engagement workshops. They felt unseen, unimportant, unheard and uninformed. They also felt bone/joint health and osteoporosis were important issues for older women (aged 70+). Osteoporosis leads to around 180,000 fractures per year causing significant pain, disability and death. The related cost is estimated at £4.4 billion a year. Women are four times more likely to suffer with osteoporosis than men and tend to suffer fractures earlier. Despite comprehensive guidelines being available, evidence suggests that osteoporosis care is lacking in primary care.

Findings will be sent to Integrated Care Boards responsible for local commissioning to facilitate ‘better fit’ services. We will produce dissemination products for wide distribution through a variety of professional networks. Academic papers will be published in journals targeted at healthcare professionals. Summary information and advice, for older women, will be disseminated via national and community networks and presentations nationwide. These outputs will be aimed at supporting successful implementation of the All-Party-Parliamentary Group recommendations for better diagnosis, treatment and management.

Aims & Objectives

How can older women and primary healthcare professionals be empowered to improve osteoporosis care?

To develop strategies to improve osteoporosis care using insights from the experience of primary healthcare professionals and older women.

Methods

Ethnographic meta-analysis literature review, in-depth interviews and co-production workshops. We will update our preliminary literature review. We will synthesise evidence from older women and healthcare professionals to identify new theoretical constructs. Findings will be reviewed in our co-production workshops and used to focus initial lines of enquiry. We will purposively sample 30 older women, from across England, aged 70+ to interview. We will also elicit the views of healthcare professionals in primary care. Interviews will explore the process of diagnosis, treatment and management of osteoporosis. Information from interviews will initially be reviewed by research staff. Following a Constructivist Grounded Theory approach, we will take our initial findings to co-production workshops on a regular basis throughout fieldwork. Workshops will facilitate iterative analysis and identify theoretical sampling gaps. This process may change the types of questions we ask or who we interview. We will combine information from all interviews to identify barriers and facilitators for older women’s osteoporosis care, and cross-reference this with existing guidelines. Professional ‘expert witnesses’ will join the workshops when required. Finally we will co-produce recommendations for improving osteoporosis care. We will also identify areas of further work that would improve osteoporosis care in the future.

Lay members will be involved in co-production workshops throughout the research. We will also work with an expert patient co-applicant in overall management of the project.

Timescales

01/04/2024 – 28/09/2025

Partners & Collaborators

Investigators:
Ms Anne Heaven (Chief Investigator)
Ms Janine Connor
Dr Jessica Johansson
Dr Nicola Kime
Mrs Christine Smith
Dr Elizabeth Teale

Collaborators:
Bradford Teaching Hospitals NHS Foundation Trust
University of Leeds

Further information

This project is funded by the National Institute for Health and Care Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number NIHR205378).

For further information please contact Anne Heaven:

Anne.heaven@bhtft.nhs.uk or 01274 382815