Abstract
Introduction
People with Parkinson's disease are more likely to have osteoporosis and falls. They also have a higher risk of fractures, and their outcomes are poorer than in the general population. Despite this, only half of the patients seen in Parkinson's clinic have a bone health assessment. The aim of this project was to improve bone health assessments in the Parkinson's clinic at Mansfield Community Hospital.
Method
One plan - do-study-act cycle was completed with the implementation of a Parkinson's fracture risk assessment tool in the clinic. 19 clinic notes were evaluated over an 8-week period. The notes were scored on whether bone health was addressed using the assessment tool. Feedback was collected from the clinicians about utilising the assessment tool in clinic. The FRAX (Fracture risk assessment) tool was also used to calculate the risk of fractures in the patients selected.
Results
16/19 (84%) notes had used the risk assessment tool in clinic. There was an improvement in the bone health assessments in clinic from 5% (1/19) at baseline to 29% (5/17). The Parkinson's risk assessment tool's identification of individuals who were high risk of fractures, correlated with those identified as high risk using FRAX. The clinicians had positive reviews of the tool, but they highlighted the time constraints.
Conclusion
Whilst the use of the assessment tool has shown some improvement in the number of bone health assessments happening in clinic; it hasn't resulted in all patients having an assessment. This is likely due to the time constraints in clinic. This project was successful in highlighting the current problem to the clinicians and has led the development of a further separate clinic, where bone heath can be addressed. The risk assessment tool plays an important role in identifying high risk patients who would be referred into this service.