Background: Minimal trauma hip fractures are a common clinical presentation of osteoporosis. After institution of a protocol for the administration of zoledronic acid at our tertiary hospital in 2019, the rates of inpatient osteoporosis pharmacotherapy increased substantially from 0% to 79% of eligible patients. However, after initiation of therapy, it is unclear if patients continue to be appropriately followed up and managed in the outpatient setting post-discharge.
Aim: This retrospective audit aims to review osteoporosis follow-up of all patients presenting to a major metropolitan hospital in Australia with a minimal trauma hip fracture over a 12-month period.
Methods: Patients admitted with minimal trauma hip fractures were identified via electronic medical records; and data on demographics, co-morbidities, anti-resorptive therapy and follow plans were collected.
Results: Overall, 150 patients between the ages of 40 and 102 years, were admitted with a minimal trauma hip fracture, with a new clinical diagnosis of osteoporosis in 110 patients. Inpatient anti-resorptive therapy was initiated in 64/110 (58%), however 3/63 (5%) and 28/63 (44%) were successfully linked in with a Fracture Liaison Service or discharged with an ongoing management plan with their GP respectively. Similarly, of the 47/110 (42%) patients who did not receive inpatient anti-resorptive therapy, 4/47 (8%) and 16/47 (34%) were successfully linked in with a Fracture Liaison Service or discharged with a plan to initiate antiresorptive therapy with their GP respectively. In conclusion, 59/110 (54%) of patients were discharged without a plan for ongoing osteoporosis management.
Conclusion: This retrospective audit highlights the gap in continuity of care in patients who present with minimal trauma hip fractures and a new clinical diagnosis of osteoporosis. Our findings emphasise the importance of transition of care discharge strategies and improved coordination in order to provide effective follow-up care for osteoporosis post minimal trauma hip fracture.