337 AN INVESTIGATION OF UNDER-TREATMENT OF KNOWN OSTEOPOROSIS IN PATIENTS WITH SUBSEQUENT HIP FRACTURE

Abstract

Abstract Background Hip fractures have long been associated with significant morbidity and mortality and threat to independent living. A major, treatable risk factor for the development of a hip fracture is osteoporosis. The objective of this study was to investigate what proportion of patients with a prior osteoporosis diagnosis admitted to acute hospitals with a new hip fracture are receiving suboptimal osteoporosis treatment. We further aimed to investigate if any demographic variables or features from clinical history and exam were associated with undertreatment. Methods Using the Irish Hip Fracture Database (IHFD), we prospectively examined patients over the age of 60 who were admitted to an acute trauma centre with a diagnosis of hip fracture, between January 2019 and December 2021. Patients were excluded if they had a pubic rami fracture or other non-hip fracture, or if they were under the age of 60. History of osteoporosis was either diagnosed by DEXA imaging or by previous fragility fracture. We also collected data on demographic and clinical variables that may be associated with being more likely to be treated with osteoporosis medications, such as age, sex, New Mobility Score, Abbreviated Mental Test Score and the American Society of Anesthesiologists grade. Results Initial data collection showed 246 patients who met our inclusion criteria, with only 97 patients (39.4%) on appropriate treatment for osteoporosis. We then applied a binary logistic regression model to our predictor variables in estimating the likelihood of a patient to be prescribed “appropriate” osteoporosis medication as previously described, however none of the selected variables were shown to have any significant value in predicting the likelihood of being undertreated with appropriate medication for osteoporosis. Conclusion This study demonstrated that 60% of patients admitted with hip fracture who had a known diagnosis of osteoporosis were undertreated for same. Treatment inertia in prescribing medications for osteoporosis must be tackled to try and remedy this.