98 Bone health: managed correctly? A clinical audit

Abstract

Abstract Background Bone health is as important in the geriatric population as any other clinical system. The International Osteoporosis Foundation states that approximately 75 million people have osteoporosis across Europe, the United States and Asia. Osteoporosis and Fragility Fractures have become a common finding in presentations to general practices and emergency departments. Clinical guidelines exist with key elements to best identify, investigate, treat, and follow up these patients—but are guidelines being followed? Methods A clinical audit and service evaluation of patients attending a geriatric assessment and treatment clinic was compared to the new 2021 United Kingdom National Osteoporosis Guideline Group publication. The comparison between strong recommendations in these guidelines and clinical practice in patients with known osteoporosis and fragility fractures was undertaken using a self-designed matrix. 28 patient files were identified, and findings recorded. Results This study suggests that bone health in geriatric patients is undertreated. Only 25% of identified patients were investigated, treated, and prescribed bone health medication as per the 2021 United Kingdom National Osteoporosis Guideline Group publication. History taking regarding comorbidities, level of mobility and frailty scoring were judiciously completed across the 28-patient sample. Referrals to allied health practitioners was lacking though patient follow up was well documented. Conclusion The key is to identify poor bone health early, act swiftly with relevant investigations and commencing medications and preventing fragility fractures and hospital admissions. Future reviews of bone health management in the geriatric populations are still required to allow full understanding on the topic.