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Aust J Rural Health. 2013 Dec;21(6):343-9. doi: 10.1111/ajr.12072.

Improving osteoporosis management following minimal trauma fracture in a regional setting: The Coffs Fracture Card Project.

Author information

1
Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia.

Abstract

OBJECTIVES:

To improve osteoporosis (OSP) management following minimal trauma fracture (MTF) with few additional resources.

DESIGN:

Population intervention with serial cross-sectional analysis.

SETTING:

Regional setting involving primary care, base hospital and private hospital.

PARTICIPANTS:

Patients with MTF.

INTERVENTION:

A 'Fracture Card' prompting OSP management was provided to all patients post-MTF. Patients were encouraged to attend their general practitioner (GP) with this to discuss bone health issues. The 2-year intervention was supported by a public health education campaign.

MAIN OUTCOME MEASURES:

Number of (i) serum 25-OH vitamin D assays, (ii) dual-energy X-ray absorptiometry (DXA) scans, and (iii) new Pharmaceutical Benefits Scheme (PBS)-subsidised prescriptions for bone protective therapy (bisphosphonates, raloxifene, strontium, teriparatide, denosumab).

RESULTS:

The number of serum 25-OH vitamin D assays ordered in Coffs Harbour increased from 329 ± 15 per month (July 2009-June 2010) to 568 ± 21 (July 2010-June 2012; P < 0.001). The number of DXA scans performed per month increased from 192 ± 14 (July 2009-June 2010) to 296 ± 12 (July 2010-June 2012; P < 0.001). There was no difference in the number of new PBS-subsidised prescriptions for bone protective therapy in the Coffs statistical subdivision over that time (176 ± 3.8 per month, July 2009-June 2010 versus 180 ± 3.5, July 2010-June 2012, P > 0.05).

CONCLUSIONS:

The intervention was associated with an increased number of 25-OH vitamin D assays and DXA scans but not with more prescriptions for bone protective therapy. This suggests that a public health education campaign and provision of a 'prompt' for GPs was only partially successful at improving OSP management post-MTF. This has driven establishment of a Fracture Liaison Service.

KEYWORDS:

fracture; minimal trauma; osteoporosis; regional

PMID:
24299440
DOI:
10.1111/ajr.12072
[Indexed for MEDLINE]

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