{
  "abstract": "Background Osteoporosis is a major public health issue, costing the UK £4.6 billion annually. Women are particularly affected, being four times more likely to experience osteoporosis than men and with fractures occurring earlier in life. Despite the availability of comprehensive guidelines for the diagnosis and management of osteoporosis, care remains suboptimal, especially in primary care settings. The Women’s Health Strategy for England highlights that older women’s healthcare needs are underrepresented, with many feeling unheard and uninformed about conditions like osteoporosis. This qualitative review seeks to explore why suboptimal osteoporosis care persists for women aged 70+, despite established guidelines.Methods We searched for articles published in English from 2008 to present, to align with the first National Osteoporosis Guideline Group publication. We searched formal databases including OVID, MEDLINE, CINAHL and EMBASE and hand searched reference lists and grey literature, including books, articles and reports published by charitable organisations. We applied qualitative filters to ensure the material had sufficient conceptual depth for analysis. We had two populations of interest: women aged 70+ and healthcare professionals working in primary care settings. We focused on research based in the UK to understand experiences in the context of the National Osteoporosis Guidelines Group recommendations. We included primary qualitative studies; qualitative reviews; mixed method studies; process evaluations; policy documents; survey data (open ended questions only) and reports including women aged 70+ as a subset. We excluded Randomised Controlled Trials quantitative systematic reviews; meta-analyses and studies not based in primary-care/community settings or the United Kingdom.Using a meta-ethnographic approach, studies were recorded in chronological order and quality appraised by two reviewers using CASP. One reviewer identified emergent metaphors that persisted over time. Two reviewers agreed a list of key metaphors. These key metaphors translated into ‘lines of argument’ which formed the basis of the final synthesis. We expressed the final synthesis as a mid-range theory.Results We identified 21 studies for full text retrieval based on the title and abstract. Two studies were subsequently discarded as out of scope. There was limited literature from the perspective of primary care. There were no papers specifically addressing diet, smoking or alcohol use and limited references to diet and exercise.Conclusion Overall, we found osteoporosis is overlooked by both patients and practitioners. Opportunities for supportive strategies are missed. Patients feel frustrated and let down. We found a reciprocal relinquishing of responsibility that led to an inertia in the management of osteoporosis as a long-term condition.",
  "authors": [
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK"
      ],
      "name": "Anne Heaven"
    },
    {
      "affiliations": [
        "Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"
      ],
      "name": "Jessica Johansson"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK"
      ],
      "name": "Matthew Prescott"
    },
    {
      "affiliations": [
        "Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"
      ],
      "name": "Tom Crocker"
    },
    {
      "affiliations": [
        "Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, Bradford, UK"
      ],
      "name": "Nicola Kime"
    },
    {
      "affiliations": [
        "Leeds Institute of Health Sciences, University of Leeds, Leeds, UK"
      ],
      "name": "Elizabeth Teale"
    }
  ],
  "title": "P07 Experiences of healthcare professionals and women aged 70 years and older in the primary care management of osteoporosis",
  "uid": "1a709920-56d8-5bec-8255-1cce3dd75a61"
}