Abstract
Background
Numerous studies have shown that osteoporosis is both under diagnosed and under treated
in patients with fragility fractures. We describe the use of an electronic automated
referral system to enable multidisciplinary assessment and treatment of osteoporosis
in patients admitted with fragility fracture of the hip.
Methods
An electronic referral system was developed from the hospital's trauma software database.
This automatically refers patients admitted with fragility fracture of the hip to
osteoporosis services. Data were collected prospectively from May to July 2007, when
referral was dependent on members of the orthopaedic team and from August to October
2007, after the implementation of the electronic referral system. Primary outcomes
were presence of a referral to osteoporosis services, organisation of bone density
scan and follow up appointment in patients less than 75 years, and treatment with
osteoporosis medication in patients greater than 75 years of age.
Results
There were a total of 90 patients, 47 in the non-intervention group and 43 in the
intervention group. In the non-intervention group 8/47 patients (17%) were referred
to osteoporosis services whilst 43/43 (100%) were referred in the intervention group.
Of patients greater than 75 years, 10/32 (31.3%) were started on a bisphosphonate
in the non-intervention group compared to 28/34 (82.4%) in the intervention group.
Of patients less than 75 years, 1/15 (7%) in the non-intervention group had a DEXA
scan booked and appropriate follow up arranged, compared to 7/9 (78%) in the intervention
group. There was significant difference between both groups in all outcomes (p < 0.0001).
Conclusion
We present an electronic system which facilitates delivery of osteoporosis services
and significantly improves management of osteoporosis in patients admitted with fragility
fracture. We recommend the use of such programmes to facilitate multidisciplinary
assessment and treatment of osteoporosis in orthopaedic trauma patients.
Keywords
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Article info
Publication history
Accepted:
May 3,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
