44 BONE HEALTH AND FRACTURE RISK: KNOWLEDGE, OPINION AND PRACTICE OF PHYSIOTHERAPISTS

Abstract

Abstract Background Osteoporotic-related fractures are responsible for excess mortality, morbidity, chronic pain, reduction in quality of life, admission to long-term care and health and social care costs (Papaioannou et al, 2010). Evidence for using Fracture Risk Assessment Tool (FRAX®) based community-screening in older people is increasing (Kanis et al, 2020). There is no published evidence on the use of FRAX® by Physiotherapists. Methods A questionnaire was sent to South Eastern Branch members of the Irish Society of Chartered Physiotherapists (ISCP). Survey themes were: participant characteristics, knowledge and opinion in the areas of Bone Health and Fracture Risk. Responses were downloaded from Survey Monkey and analysed using descriptive statistics. Results The response rate was 27% (n = 56). 72% (n = 40) of those surveyed had at least 10 years clinical experience. For 65% (n = 37) of participants, older people made up more than half of their clinical caseload. 96% (n = 54) of participants treated people with frailty and other bone health risk factors; falls (93%), osteoporosis (89%), fracture or reduced mobility (87%). On a scale of 1–10 (1 = least confident, 10 = most confident) 49% of respondents rated confidence in prescribing Bone Health Physiotherapy interventions at ≤5. When interpreting results of a DEXA scan; 80% reported confidence to be ≤5. Half (49%) of participants had never heard of FRAX®. 95% of respondents felt fracture risk was under addressed in clinical practice. All felt it was within their professional responsibility to discuss fracture risk with patients. Conclusion This is the first evaluation of bone health and fracture risk knowledge, opinion and practice of physiotherapists. The need for more knowledge of DEXA, FRAX® and bone health was highlighted. The use of FRAX® may improve fracture risk assessment in patients attending Physiotherapy. Based on these results, FRAX® has been introduced into a Rehabilitation Unit by Physiotherapists as part of Quality Improvement Project.