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When continuity of care breaks down: a systems failure in identification of osteoporosis risk in older patients treated for miminal trauma fractures

Kelly, Anne-Maree and Clooney, Megan and Kerr, Debra and Ebeling, Peter (2008) When continuity of care breaks down: a systems failure in identification of osteoporosis risk in older patients treated for miminal trauma fractures. Medical Journal of Australia, 188 (7). pp. 389-391. ISSN 0025-729X

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Abstract

Objective: Minimal trauma fractures may be the first indication of osteoporosis. Our aim was to determine the proportion of patients who underwent bone density testing for osteoporosis of those with a minimal trauma wrist fracture treated in the emergency department (ED). Design: This observational retrospective cohort study used explicit medical record review and scripted telephone interviews. Setting: EDs of three metropolitan hospitals in Melbourne in 2006. Participants: Patients aged 50 years and over who were treated for wrist fracture due to minimal trauma. Data collected included demographic details, fracture details, causes of injury, any bone density testing and any osteoporosis-related medication change. Main outcome measure: The proportion of patients who underwent bone density testing in the follow-up period. Results: 131 patients were studied; 83% were female, and the median age was 71 years. No patient was referred by an ED or fracture clinic for bone density testing (95% CI, 0–3.5%). Telephone follow-up data were obtained from 91 patients. Of these, 28 reported having bone density testing after their fracture, of whom 14 (50%; 95% CI, 32%–67%) were found to have osteoporosis. Seven were treated with a bisphosphonate and one with a selective oestrogen-receptor modulator. Conclusion: Follow-up of patients suffering minimal trauma wrist fractures treated in the ED is poor. Systems to improve the identification and treatment of osteoporosis in this group are needed if future osteoporotic fractures and their consequences are to be avoided.

Item Type: Article
Uncontrolled Keywords: ResPubID14762, minimal trauma fractures, osteoporosis, bone density testing, minimal trauma wrist fracture, emergency department (ED)
Subjects: Faculty/School/Research Centre/Department > School of Nursing and Midwifery
FOR Classification > 1117 Public Health and Health Services
SEO Classification > 9202 Health and Support Services
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Depositing User: VUIR
Date Deposited: 31 Aug 2011 05:23
Last Modified: 04 Apr 2013 00:14
URI: http://vuir.vu.edu.au/id/eprint/3747
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