Two-country comparison of the prescription of bone protection medication before and early after hip fracture.

Autor: Halim NK; Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia., Harris RG; Australian and New Zealand Hip Fracture Registry Steering Group, Auckland, New Zealand., Cameron ID; John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District and Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia., Close J; Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia.; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia., Harris IA; Ingham Institute for Applied Medical Research, School of Clinical Medicine, UNSW Medicine and Health, UNSW, Sydney, Australia., Hallen J; Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia., Hurring S; Canterbury District Health Board, Christchurch, New Zealand., Ward N; Australian and New Zealand Hip Fracture Registry Steering Group, Auckland, New Zealand., McDougall C; Surgical Treatment and Rehabilitation Service (STARS) and The Prince Charles Hospital, Metro North Hospital and Health Service, Queensland and Faculty of Medicine, University of Queensland, St Lucia, Australia., Mitchell RJ; Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia. r.mitchell@mq.edu.au.
Jazyk: angličtina
Zdroj: Archives of osteoporosis [Arch Osteoporos] 2022 Dec 12; Vol. 18 (1), pp. 8. Date of Electronic Publication: 2022 Dec 12.
DOI: 10.1007/s11657-022-01197-4
Abstrakt: Pharmacological management of bone health warrants investigation into factors influencing initiation of bone protection medication (BPM) at discharge after a hip fracture. This sprint audit identified reasons attributed to low BPM treatment levels at hospital discharge which can guide improvement in the prevention of future fractures.
Purpose: To compare patient characteristics and Australian and New Zealand approaches to prescribing bone protection medication (BPM) pre- or post-hip fracture, determine reasons why BPM was not prescribed earlier post-fracture, and assess the generalisability of sprint audit and the Australian and New Zealand Hip Fracture Registry (ANZHFR) patient cohorts.
Methods: A retrospective cohort study of hip fracture patients from the ANZHFR aged ≥ 50 years (2016-2020) and consecutive patients from the 2021 BPM sprint audit. Multivariable logistic regression was used to examine factors associated with not prescribing BPM.
Results: Of 55,618 patients admitted with a hip fracture in the ANZHFR, less than 10% of patients in Australia and New Zealand were taking BPM on admission, increasing to 22.4% in Australia and 27.8% in New Zealand on discharge. Registry patients who were younger (50-69 years), healthy (ASA grade 1), lived in a residential aged care facility, had impaired cognition, delirium identified, or were awaiting a specialist falls assessment were less likely to take BPM. Within the audit, 46.2% of patients in Australia and 39.2% in New Zealand did not have BPM in their discharge prescription. The most common reason for not prescribing BPM in Australia was low level of vitamin D (13.3%), and in New Zealand, renal impairment (14.8%). Sprint and registry patient characteristics were comparable in terms of patient age, sex, usual place of residence, and ASA grade.
Conclusions: BPM prescription early after hip fracture is low. Opportunities exist to increase the rate of prescription of medications known to prevent future fractures in this high-risk population.
(© 2022. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)
Databáze: MEDLINE
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