Abstract
Promoting Bone Health by ensuring in-patient Ortho-geriatrician Bone Health plan in patient notes following Neck of Femur Fracture (NOF).
- Introduction & Aims
Osteoporosis affects 3 million people in the UK with more than 500,000 hospital presentations annually due to fragility fractures costing in excess of £4.4 billion to the NHS. Bone protective medications are a cost-effective way of reducing fracture and admission following a fall.
The Royal College of Physicians National Hip Fracture Database targets that patients are: “given suitable bone strengthening treatment and followed up to ensure that they are still receiving this protection 120 days after fracture”. Lewisham Hospital achieves this in only 22% of suitable patients against a national average of 35%.
This project aimed to increase the number of eligible NOF patients on bone protective medication.
- Method
Data was collected for patients over the age of 65 admitted with NOF. 22 eligible patients were admitted from 01/01/23 to 28/02/23 and 16 from 01/03/23 to 31/05/23. It was identified whether an appropriate bone health plan, including FRAX and calcium/vitamin D supplementation, was recorded in the medical notes and electronic departure note (EDN). Interventions included an advice sheet for rotating doctors, additional education at induction and a bone health proforma for medical notes and EDNs.
- Results
86% of patients in cohort one had bone health plans in their notes and 59% in their EDN. 64% commenced on bisphosphonates with 1 eligible patient (4.5%) not receiving medication. After the interventions 100% patients had a bone health plan in their notes and 80% on their EDN. 46.7% of this cohort commenced bisphosphonates which equated to 100% of patients appropriate for bone protective medication.
Conclusion(s)
Providing guidance and education to rotating doctors to ensure Geriatrician-led bone health planning resulted in all eligible patients commencing bone protective medication and total numbers above the national average.