Title : Osteoporosis vertebral fractures – Assessment and intervention using frax tool
Abstract:
Introduction: Osteoporosis is the most prevalent systemic skeletal disorder affecting the bone structure leading to increased risk of bone fractures and disability among the population. Osteoporosis is a characterized by low bone mineral density. Over 500,000 patients with fragility fractures present to UK hospitals each year. Previously a pathway was established to assess the asymptomatic fractures and a referral pathway to fracture liaison services were created locally. We are looking to improve efficiency of the pathway since the time it was implemented. Since inception of Frailty Bone Health clinic in August 2020, new pathway agreed for specialist clinic follow up (>65 years to frailty bone health clinic, <65 years/or already under care of rheumatology clinic).
Aims: To improve completion rate of NOGG defined standards for patients presenting with vertebral fractures under orthopaedic care.
Materials and Methods: 47 patients were assessed for osteoporotic risk fractures in line with standard NOGG admitted under Orthopaedic care at RAEI, Wigan, UK.
Results: 29 out of 47 (61%) individuals in the cohort have had previous fractures, which increases the risk of subsequent osteoporotic fractures. Frax calculated and documented – 68%, Mineral bone bloods checked – 72.3%, DEXA ordered – 63.6%, referral to specialist clinic – 56%, initiated on bone protection – 80%.
Conclusions and Discussion: We had established a referral pathway (>65 years to elderly care clinic, <65 years to rheumatology clinic) and educated junior doctors to make the referrals as appropriate, included FRAX calculation as part of training and induction. On implementation of FRAX tool on HIS has been user friendly. We have seen significant improvements in the documentation using FRAX tool and increased number of referrals to specialist care.
