3PREVENTING FRACTURES: CAN DOCTORS IMPROVE THEIR BONE PROTECTION PRESCRIBING?

Le résumé fourni par la source

Correct prescribing of bone protection in the elderly is important to minimise the risk of osteoporosis, thus to prevent fragility fractures. 50% of patients with hip fractures who were previously independent become dependent on others. This results in social, financial and psychological implications on the patient and prolonged hospital stays. Therefore, we aim to check whether the correct bone protection was prescribed, according to NICE, to patients on the geriatrics and acute wards, over the age of 65 years, in a month's period. This was then reaudited after our strategy was put in place. Before re-audit, posters were put on the acute and geriatrics wards on guidance on how and when to prescribe bone protection and were explained. Also, recommendations were verbally delivered to doctors and drug charts were checked. Over the course of a month, in cycle 1, 15 patients met the criteria of having bone protection. 7/15 (46.7%) were correctly prescribed bone protection. The most common reason why patients met the criteria for bone protection was ‘all patients over 65 years who were recurrent fallers and are housebound’. After our intervention, 23 out of 33 (70%) were prescribed the correct bone protection. ‘Patients over the age of 65 and are housebound’ was the main reason for bone protection being prescribed. ‘Patients over the age of 65 and housebound’ was also the commonest category where doctors had not prescribed bone protection, that being 7/33 patients. The acute wards showed an improvement in correct bone protection prescribing from 25% to 50%. The geriatrics wards improved from 55% to 76%. Even though, there was an overall improvement in correct bone protection prescribing, further improvement can be made, more so, on the acute wards. It has been identified that mainly housebound patients missed out on bone protection. Post re-audit, further education of correct bone protection prescribing was delivered in the doctors meeting to inform them in which categories they fell short. We would like to improve this audit by increasing sample size by increasing the time period for data collection.

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