In Australia, osteoporosis & fracture risk increase exponentially with age. One in two women and one in three men over 60 years will have an osteoporotic fracture. Approximately 50% of people with one fracture due to osteoporosis will have more. Someone is admitted to hospital with an osteoporotic fracture in every 5-6 minutes.
The NSW Health initiative from the Agency for Clinical Innovation has identified this area as an issue of significant need and proposed a fracture liaison officer model to meet these needs. The Department of Endocrinology, Prince of Wales Hospital, believes this unmet need will be best addressed by creating nursing led liaison positions.
At present the role extends to identification of young inpatients at the time of discharge who do not have an osteoporosis investigation and management plan and the education of those elderly patients requiring education and treatment with teriparatide. A plan for screening the fracture clinics is being developed. Since 2011 till now, 128 patients have been identified via fracture liaison. The fracture conditions are: wrist-20.8%; hip-5.4%; humerus-7%; and foot, clavicle, calcaneous-each 4.6%.
Many of the skills applicable to diabetes education are directly relevant to the patient education
of patients commencing teriparatide. In total, 60 patients have been taught and followed up
using teriparatide injection.An evaluation with pre- and post- education questionnaire for this
education session has been approved by Human Research Ethics Committee. Patients’ (N=17)
feedback explores several aspects: knowledge of osteoporosis, reasons for teriparatide
injection and information provided prior to education session. The qualitative findings
suggested that osteoporosis is `broken bones, fracture…’; and the majority of
the patients don’t want to have any materials given prior to education session and would
prefer face to face teaching. This information will be useful for designing future education
program for patients with osteoporosis.