An audit of osteoporotic patients in an Australian general practice

Osteoporosis is a major contributor to morbidity and mortality in Australia, and is predicted to accelerate as the population grows and increases in age. The aim of this study was to audit 10 general practitioners for their identification of patients with risk factors for osteoporosis, and appropriate screening, treatment and follow up care.

Patient medical records over a 12 year period from 10 GPs at a rural medical centre were retrospectively audited using the PENCAT software. The management of osteoporosis was compared with guidelines from The Royal Australian College of General Practitioners.

The study included 402 patients, both men and women, aged 60-95 years, with at least one risk factor in addition to age. Only 35% of all patients had been scanned for osteoporosis, and the percentage varied with age, gender, and number and type of risk factors. Overall, 66% of patients with osteopenia, and 26% with osteoporosis, were receiving no medical treatment. Additionally, 48% of those with previous low bone mineral density scans had not had recommended follow up scans.

General practitioners are the healthcare hubs of our communities, including for prevention of diseases such as osteoporosis. The low level of concordance with the guidelines suggests that in this general practice community, passive screening for osteoporosis has been less than effective. Active surveillance, such as the PENCAT tool used in this study, would offer an alternative approach. Further studies could then evaluate whether incorporating this into the usual practice audit process leads to improved patient outcomes.