Endocrine Abstracts

Background: Hip fractures are associated with high morbidity and mortality rates amongst older adults. The Irish Hip Fracture Database Standard 5 requires that all patients with a hip fracture have a bone health assessment completed. The majority are prescribed bone protection therapy to reduce further fractures. We sought to analyse the compliance and receipt of bone protection in patients presenting for DXA scan post hip fracture.

Methods: We retrospectively assessed receipt of bone protection therapy in 20 consecutive patients at presentation to DXA post hip fracture from April to July 2021. This was captured on the bone health questionnaire administered by the DXA technicians. Subsequently, we examined their medical notes to see the result of their bone health assessment and to investigate whether despite recommendations from their orthogeriatrician the patients had not received adequate bone protection therapy.

Results: 14/20(70%) patients who had had a hip fracture were clearly taking prescribed bone protection therapy on presentation to DXA at St. Vincent’s University Hospital (SVUH). In the remaining 6/20 (30%) it was unclear from discharge letters or prescriptions if they were in receipt of adequate protection. Analysis of medical notes revealed 2/20 (10%) had been discharged with the advice to start denosumab with their GP, 2 (10%) received IV Zoledronic acid prior to transfer to rehab. 1 (5%) was discharged for IV zoledronic acid as an OPD which has not been administered. 1 patient was discharged without adequate bone protection despite an orthogeriatrician recommendation. Zoledronic Acid was the most prescribed bone protection agent (45%), followed by denosumab (40%).

Conclusion: Despite clear recommendations from orthogeriatricians not all patients were in receipt of recommended bone protection therapy on presentation to DXA. Standardized templates for discharge letters to GPs and outpatient DXA clinics may help to improve compliance.