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February 8, 2026Age and Ageing0 citations

3692 Orthogeriatrics: improving assessments and the use of bisphosphonates

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AGA D GlascowWRW RycroftMMMark T Mills

Key Points

  • To enhance the quality of Orthogeriatric Assessments and increase bisphosphonate use for secondary fracture prevention in hip fracture patients.
  • Implemented 12 hours per week of Consultant support and recruited a Specialty Doctor.
  • Introduced an electronic proforma for consistent Orthogeriatric Assessments.
  • Targeted assessment of patients over age 60 with hip fractures within 72 hours of admission.
  • Increase in Orthogeriatric Assessments completed within 72 hours from 0% to 85.7% over five months.
  • Bisphosphonate treatment initiation rose from 13.1% to 59.5% among hip fracture patients during the same period.

Abstract

Abstract Introduction At Doncaster Royal Infirmary we targeted an improvement in the care of patients admitted with a hip fracture. The first objective was to deliver more consistent Orthogeriatric Assessments. The second objective was to improve bone health assessments and the use of bisphosphonates for secondary prevention of fragility fractures. Method After a period of limited Orthogeriatric service, from January 2025, new medical support was provided in the form of 12 hours per week of Consultant time and support from a recently recruited Specialty Doctor. This supported the existing Specialist Nurse and Pharmacist. We introduced a bespoke electronic proforma for Orthogeriatric Assessments and aimed to see all new patients over age 60 yrs admitted with a fractured hip within 72 hours of admission. As part of this process we aimed to improve the use of bisphosphonates for secondary prevention of fragility fractures. Results Objective 1—Orthogeriatric Assessment: The number of Orthogeriatric Assessments completed within 72 hours improved from 0% in December 2024 to 11.5% (January 2025), 18.9% (February), 41.4% (March), 77.6% (April) and 85.7% (May). Objective 2—Bisphosphonates The percentage number of patients started on bisphosphonate treatment increased from 13.1% (December 2024) to 16.9% (January 2025), 43.5% (February), 46.3% (March), 66.1% (April) and 59.5% (May). Conclusion More patients admitted to Doncaster Royal Infirmary with a hip fracture now receive an Orthogeriatric Assessment within 72 hours. This has resulted in a significant increase in the number of patients started on bisphosphonate treatment for secondary prevention. There are common clinical concerns that can limit the use of bisphosphonates. Some of these can be overcome with the latest evidence-based medicine and balancing risks and benefits.1 Reference 1. Johansen A, Sahota O, Dockery F. et al. Call to action: a five nations consensus on the use of intravenous zoledronate after hip fracture. Age and Ageing 2023;52:–.

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Cite This Study

Glascow et al. (2026) studied this question.

synapsesocial.com/papers/698827e20fc35cd7a8846e38https://doi.org/10.1093/ageing/afaf368.018
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