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Fast forward - 1 May 2012
MO looks back 10 years, casting a fresh eye over what made news in 2002. Then we hit the fast-forward button to see what’s changed.
TEN years ago Osteoporosis Australia (OA) was calling for a dedicated osteoporosis GP in every division of general practice, and bone mineral density (BMD) test rebates for everyone older than 65.
The proposal, put to the Medicare Services Advisory Committee (MSAC) in 2002, also called for pharmacotherapy to be subsidised for prevention and for “first fracture” clinics at hospitals.
Reimbursement for DXA scans for people older than 70 and at high risk of secondary osteoporosis was announced in 2006, and now BMD tests are rebatable for everyone older than 70, not just post-fracture. OA is now seeking to further extend Medicare-funded DXA screening.
Its medical director Professor Peter Ebeling said: “We have made a submission to Medicare to lower the age for Medicare reimbursement for BMD tests [to people younger than 70 with recognised risk factors] and also include eligibility for patients on aromatase inhibitors for breast cancer and those living with HIV.”
OA’s chief executive officer Shelley Evans was optimistic that Medicare Locals would play a key role in bone health management in future.
Professor Ebeling, head of endocrinology at Western Health, Melbourne, said OA considered it a viable option to have dedicated osteoporosis GPs at Medicare Locals when the fracture liaison service was rolled out.
Duties could include osteoporosis treatment, management, patient education and liaison with “first fracture” clinics, he said.
Ms Evans said there were several successful re-fracture prevention clinics in Australia and OA was investigating methods of extending this model nationwide.
“We have come a long way in 10 years,” she said.
“We have seen a decrease in the rate of hospital separations for minimal trauma hip fracture but an increase in the absolute number of these fractures due to the population ageing.
“By 2021 a fracture will occur every 3.5 minutes.
“GPs are in an excellent position to promote good bone health… and to recognise risk factors and recommend DXA scans for those at greatest risk.”