A new initiative in osteoporosis re-fracture prevention in SESLHD

A large number of patients who suffer a fracture following a fall or traumatic injury subsequently succumb to secondary fractures. In the elderly, these secondary fractures tend to affect major bones, and are often associated with significant loss of independence, morbidity and mortality. The rates of undiagnosed bone disease (osteoporosis and osteopenia) is as high as 30-50 per cent in elderly patients who suffer a primary fracture, and acute hospital-based care of the injury often fails to diagnose the underlying cause. By identifying these patients and reviewing them in an outpatient setting, these underlying causes can be diagnosed and treated effectively, lowering their risk of subsequent fractures.

The combined Osteoporosis service and Bone Density Unit at RHW and POWH has developed a new Osteoporosis Re-Fracture Prevention service in which radiology reports are reviewed in real-time to rapidly identify patients with fracture who are at risk of bone disease. Those patients are referred for a Bone Mineral Density and screening for secondary causes of osteoporosis. Following this, patients are seen in a multidisciplinary clinic by an endocrinologist with a special interest in Osteoporosis, and a Fracture Liaison Coordinator and physiotherapist. Recommendations for appropriate treatment regimens and advice on falls prevention are made. The advice is then communicated to the patients’ GP and can be instituted and managed in the community setting. This service aims to improve patient outcomes, reduce overall morbidity and reduce costs to the healthcare system.

The anticipated benefits include:

  • Early identification of patients with osteoporosis who are at risk of more fractures
  • Reduction of subsequent fracture and falls in patients with osteoporosis due to early therapeutic interventions
  • Reduced morbidity in patients with bone disease
  • Improved quality of life and independent living
  • Reduction of hospital admissions for subsequent and more complex fractures
  • Reduced expenditure on orthopaedic interventions in the elderly

Should you wish to refer your patient for a Bone Mineral Density scan the Bone Density department can be contacted on (02) 9382 6617.

Should you wish to refer a patient with a previous low trauma fracture for investigation, please fax a referral to Dr Amanda Beech, c/o POWH Endocrinology, on fax number 9382 4688.