Examining Post Hip Fracture Bone Protection At 30 days After Admission To An Irish Hospital

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Abstract Background The Irish Hip Fracture Database (IHFD) includes a national standard of bone assessment during the acute episode of care. Furthermore, IV Zoledronic Acid (IVZ) is now recommended after hip fracture to provide longer term bone protection. It is not known however, how many patients commence appropriate bone therapy, by 30 days after admission. This audit aimed to examine commencement of bone protection medication for hip fracture patients across one acute hospital and its associated rehabilitation sites. Methods A retrospective audit was conducted. Consecutive patients admitted between December 2022 and December 2023, with hip fracture to a single acute hospital were included. Patients that did not meet IHFD inclusion criteria, were excluded. Patients were contacted in-person or by telephone by a physiotherapist to ask about bone-protection medication at 30 days after hip fracture admission, as part of a broader follow-up. Results A total of 146 patients were included for follow-up at 30 days after hip fracture admission. Of these patients, n=13 (9%) had died within this time and n=7 were not contactable at 30 days. A further n=8 (5%) did not receive bone-health follow-up. Only n= 3 patients contacted were not started on bone medication because it was contraindicated. While it is known that many patients were given IVZ as inpatients, it was not possible to determine this information accurately from patient report or current information recorded in the IHFD. Conclusion Most participants were administered bone protection medication by day 30 post hip fracture admission, however in some cases this was difficult to determine. The process of conducting the audit has improved commencement and recording of specific medication, in particular IVZ. The introduction of long-term outcomes into the IHFD should facilitate our hospital to benchmark our bone protection coverage nationally.