67 How Well is Osteoporosis Checked for and Treated in Those Admitted with Fragility Fractures on General Medical Call?

Abstract

Abstract Background Patients suffering a fragility fracture should be assessed and considered for treatment for osteoporosis according to current guidelines. This retrospective audit set out to assess if diagnosis and treatment of osteoporosis occurred appropriately in those admitted to a Model 2 Hospital with non-hip fractures on general medical call under all specialities. Methods All patients, admitted with fragility fractures, between January and June 2018, were included. Hip fracture patients treated through a separate ortho-geriatric rehab pathway were excluded. Data including source of admission, length of stay, type of fracture, investigations, treatments initiated or planned, were identified from patient’s records and collated using excel statistical analysis. Results From a total of 64 fracture admissions, 38 cases were non-Hip fractures. 34% (n=13) male, average age was 84 and 40% (n=15) patient had a history of previous fracture. Once admitted 68.4% (n=26), 60.5% (n=23) and 50.0% (n=19) had Vitamin D level, Bone profile and Serum Protein Electrophoresis checked respectively. Three patients passed away. 37% (n=13/35) of patients had a DXA scan performed either during or after their admission, all of whom were diagnostic for osteoporosis. 50% (n=19/38) were on Vitamin D at time of admission while 77% (n=27/35) were discharged on Vitamin D supplementation. 8% (n=3/38) were on osteoporosis treatment at time of admission while 31% (n=11/35) were discharged on, or had a plan in place for, osteoporosis treatment. Conclusion Investigation for and management of osteoporosis in patients admitted with fragility fractures are not being adhered to as per recommended guidelines. A new pathway under the supervision of a newly appointed c/RANP is being developed, in line with osteoporosis guidelines as a result, with a view to re audit and better follow-up of these patients.