PRO‐OSTEO Extend I study (improving osteoporosis management in the acute and rehabilitation settings): multicentre audit

Background Osteoporosis contributes to a large number of admissions to hospitals after minimal‐trauma fractures but is poorly recognised as an underlying cause of admissions and may be inadequately managed following hospitalisation. Aim The aim of this study was to examine osteoporosis management across Peninsula Health, assessing the effect of the introduction of a standard form to guide osteoporosis management after minimal‐trauma fractures. Method This was a retrospective cohort study measuring rates of osteoporosis assessment and treatment for patients admitted with minimal‐trauma fractures. Two periods were compared (in 2012 and 2013), before and after the introduction of an osteoporosis management form that allowed a pharmacist‐driven approach to management. The study end points were the extents of use of the osteoporosis form and the rates of osteoporosis assessment and treatment. Results Osteoporosis assessment and treatment rates varied widely across Peninsula Health, with acute wards such as the emergency departments providing no assessment or treatment (before and after the intervention). The uptake of the osteoporosis management form was negligible in the post‐intervention period. The overall 2‐year mortality rate was 7.4% following any fracture within 2 years of admission, and up to 33% following a hip or neck of femur fracture at some sites. Conclusion Osteoporosis management remained inadequate in the hospital settings despite intervention. Strategies such as ongoing prescriber education and employment of a local change champion specialised in osteoporosis management with support from all departments may be needed to achieve the aim of lowering the morbidity and mortality associated with this disease.