Heaven, A., Kime, N., Shafiq, S. et al. (5 more authors) (2026) “I have no idea who does the bone thing” A qualitative exploration of older women and healthcare professionals’ experiences to guide improvements in osteoporosis care. British Journal of General Practice. ISSN: 0960-1643 (In Press)
Abstract
Background
The Older Women's Health Strategy for England highlighted the systemic under-representation of older women in healthcare. Over half of women over 80 are estimated to have osteoporosis, contributing to 180,000 fractures annually in the UK, with substantial personal and economic costs, despite clinically effective treatments and national guidelines being available.
Aim
To use insights from the experiences of older women and primary healthcare professionals to develop strategies to improve osteoporosis care.
Design/Setting
A community-based study in England, UK. Method Interviews with 30 community-dwelling older women (aged 70+) diagnosed with osteoporosis, and 31 healthcare professionals including GPs, physiotherapists, pharmacists, practice nurses, a healthcare assistant, and a community matron. We reviewed findings iteratively with our co-production group using a Constructivist Grounded Theory approach.
Results
Healthcare professionals acknowledged osteoporosis as clinically important but described limited knowledge and understanding. However, older women assumed expertise and proactive engagement from clinicians. Older women normalised symptoms as part of ageing frequently prioritising other co-morbidities. Most were unclear about their diagnosis, prognosis, or treatment plans. Self-management was expected but inadequately supported. There was little routine engagement with the wider primary care team. Digital communication further limited older women's engagement/re-engagement.
Conclusion
Osteoporosis remains poorly understood and inadequately managed in older women who face barriers, including multimorbidity, digital exclusion, and low self-efficacy. Many older women accept care gaps due to limited awareness and lack of meaningful interaction with healthcare professionals. Improved care navigation and greater involvement of the wider primary care team could enhance engagement and support better self-management.
Metadata
| Item Type: | Article |
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| Authors/Creators: |
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| Keywords: | Old*; Osteoporosis; Women’s Health < Patient groups; grounded-theory; primary-care; self-management; women |
| Dates: |
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| Institution: | The University of Leeds |
| Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
| Funding Information: | Funder Grant number NHS National Inst. for Health Research NIHR Department of Health M20141 |
| Date Deposited: | 23 Jul 2026 15:11 |
| Last Modified: | 23 Jul 2026 15:11 |
| Status: | In Press |
| Publisher: | Royal College of General Practitioners |
| Identification Number: | 10.3399/bjgp.2026.0003 |
| Related URLs: | |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:243133 |

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