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01-10-2005 | Original Article

The effect of a fracture protocol on hospital prescriptions after minimal trauma fractured neck of the femur: a retrospective audit

Authors: Graeme Jones, Sandi Warr, Emma Francis, Timothy Greenaway

Published in: Osteoporosis International | Issue 10/2005

Abstract

Effective therapies for the treatment of osteoporosis and fracture have been available for a number of years. Despite this, there are numerous reports indicating very low uptake rates in those admitted to hospital with fracture. The aim of this retrospective audit was to assess the impact of a fracture protocol on inpatient prescriptions of osteoporosis therapy. A fracture protocol was arrived at by consensus and was based on recommendations from the Australian Fracture Prevention Summit, which included specific advice on the commencement in hospital of calcium, vitamin D, synthetic estrogen receptor modulators (SERMs) and bisphosphonates. We studied subjects who were treated for fractured neck of the femur at Royal Hobart Hospital from March 2002 to March 2004 and included 161 prior to the start of the protocol and 93 after. As compared to the baseline period, subjects after the introduction of the protocol had higher rates of in-hospital prescription for any treatment (58 vs. 36%, P <0.01), calcium (51 vs. 26%, P <0.01), vitamin D (48 vs. 29%, P <0.01) and oral bisphosphonates (24 vs. 5%, P <0.01), but not SERMs as expected (1 vs. 1%, P =0.70). Additional factors affecting the decision to start any treatment included in-hospital death (OR 0.16, 95% CI 0.05–0.49), dementia (OR 0.39, 95% CI 0.21–0.74), a trend for female sex (OR 1.79, 95%CI 0.96–3.36), but not age. In conclusion, a structural approach to changing hospital policy from the top down is effective at substantially increasing the usage of effective therapy after fractured neck of the femur.

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Title: The effect of a fracture protocol on hospital prescriptions after minimal trauma fractured neck of the femur: a retrospective audit
Authors: Graeme Jones
Sandi Warr
Emma Francis
Timothy Greenaway
Publication date: 01-10-2005
Publisher: Springer-Verlag
Published in: Osteoporosis International / Issue 10/2005
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-005-1960-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The effect of a fracture protocol on hospital prescriptions after minimal trauma fractured neck of the femur: a retrospective audit

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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