1213 IMPROVING INITIAL SCREENING, INVESTIGATION AND INTERVENTION OF BONE HEALTH IN A DAY REHABILITATION UNIT

Abstract

Abstract Topic We identified a deficiency in the identification and treatment of bone health in the Day Rehabilitation Unit. DRU is an Out-patient clinic where older people with falls or reduced mobility receive comprehensive geriatric assessment. We aimed to improve early screening for osteoporosis, prompting targeted investigation and intervention to improve patient outcomes. Intervention Our first intervention was consultant teaching specifically to the junior doctors working in clinic. This was followed up by the introduction of a Medical Assessment Proforma to include osteoporosis risk assessment. Finally, we had departmental wide teaching on bone health assessment. We hypothesised that a combination of clinical education and prompts in the proforma would improve our practice. A total of 205 patients where audited across an 18-month period from Sept 20 to Feb 22. We reviewed the electronic care record of patients seen in clinic to determine if bone health had been considered. A spreadsheet was designed in accordance with the NICE1 guidelines to record data. This included what supplements were prescribed, if a FRAX score had been recorded and the outcome of this. Improvement We noted an improvement in supplements prescribed (from 27% to 83%), FRAX score recorded (from 0% to 100%). Routine bloods including serum calcium remained unchanged (100%). Recording of Rockwood score also saw an improvement (from 0% to 49%). Discussion Increased use of a structured screening tool, supported by targeted education improves recognition and intervention of bone health. 54% of people who had a FRAX score done required a DEXA as per guidelines, of these 26% have osteoporosis. This early intervention helps to prevent osteoporotic fractures, therefore improving the quality of life of our elderly population. Reference 1. Nice.org.uk. (2017). Osteoporosis: assessing the risk of fragility fracture | Guidelines| NICE. [Online] Available at: https://www.nice.org.uk/guidance/cg146.