Collaborative approach important for management of osteoporotic fracture
MedWire News: Australian research has shown that a multidisciplinary team-based model of care can significantly improve identification of patients with osteoporotic fractures who are at risk for refracture.
The care model can also improve treatment uptake and ongoing management, says the group, who developed the approach to increase the referral of patients over 50 years of age presenting to the emergency (ED) at the Royal Newcastle Centre and John Hunter Hospital in Newcastle, New South Wales, with a minimal trauma fracture (MTF).
The research team - established in August 2007 - included stakeholders from the osteoporosis fracture prevention clinic (FPC), ED, fracture clinics, orthopedic wards, community health teams, physiotherapy, falls prevention team, allied health, general practice, as well as consumer representation, and health information technology experts.
They developed and piloted an electronic flagging system and data acquisition tool and established a referral pathway to detect, manage, and follow up patients, which was coordinated by a fracture prevention nurse (FPN).
Patients presenting with a MTF are identified by their ED presentation via a weekly electronic report. These patients are then tracked to see if they have entered the referral pathway. If they haven't already been referred to the FPC, the FPN will send them a referral letter.
The FPN also provided staff with a half-day education workshop regarding the importance of osteoporosis assessment and treatment.
Lead author of the study Michelle Giles (John Hunter Hospital) and colleagues report that between 2007 and 2009, 2049 patients over the age of 50 presented to ED with a MTF.
As a result of the fracture prevention model, the proportion of patients attending the FPC increased significantly from 11% in 2007 to 29% in 2008.
In addition, the time from fracture to clinic attendance decreased significantly from 68 days in 2007 to 44 days in 2009.
"In line with other studies, the results of this project demonstrate the need for, and effectiveness of, a coordinated and systematic approach to assessment and treatment of osteoporosis in older people who were presented to ED with an MTF," conclude Giles et al in the journal Osteoporosis International.
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By Laura Dean