Improving osteoporosis assessment in the fracture clinic

Area of Science:

• Orthopaedics
• Gerontology
• Public Health

Background:

• Osteoporosis assessment services are crucial for managing bone health, particularly in fracture clinics.
• Effective patient referral pathways are essential to maximize the utility of these services.

Purpose of the Study:

• To compare the efficacy of different patient referral methods to an osteoporosis assessment service.
• To identify the most effective strategy for increasing patient catchment in an orthopaedic fracture clinic.

Main Methods:

• Evaluation of three distinct referral methods: physician-led referral, patient self-referral, and referral facilitated by a specialist nurse.
• Assessment of catchment rates for each referral method within a UK hospital's orthopaedic fracture clinic.

Main Results:

• Physician-led referrals yielded a low catchment rate of 1.6%.
• Patient self-referral significantly increased catchment to 63% (P < 0.0001).
• The presence of a specialist osteoporosis and fracture liaison nurse achieved the highest catchment rate of 77% (P = 0.036).

Conclusions:

• Establishing an osteoporosis assessment service with strict referral criteria alone is insufficient to maximize patient numbers.
• A dedicated, in-clinic specialist nurse is the most effective method for identifying and referring eligible patients.
• Investment in osteoporosis and fracture liaison nurses is recommended to improve osteoporosis care and patient outcomes.