Improving bone health assessment in a geriatrics unit

Improving bone health assessment in a geriatrics centre:

Natalie Maria Jones IMT3

Introduction:

The National Osteoporosis Guideline Group (NOGG) quotes that one in five men and one in two women will experience a fragility fracture in their lifetime. The cost of fragility fractures to the NHS in 2019, exceeded £4 billion (1). An important and often overlooked aspect of falls assessment is that of osteoporosis detection and treatment. This project aimed to improve % of patients receiving a bone health assessment within a tertiary geriatric unit to 100% by September 2025.

Method:

The project took place across a three-month period between July 2025-September 2025. Data collected included % appropriate assessment of vitamin D and calcium levels and % appropriate FRAX assessment versus direct referral for bone mineral density imaging. Two intervention cycles have been implemented including an educational session on bone health assessment and the introduction of an algorithm for bone health assessment. A further intervention is planned in the form of an computer 'smart phrase' for bone health assessment documentation.

Result:

Baseline data demonstrated 40% of patients received an appropriate assessment of vitamin D and calcium levels, whilst 30% of patients received appropriate FRAX assessment +/- DEXA scan assessment/referral. Preliminary data has demonstrated an improvement in % of patients receiving appropriate bone health assessment to 60% across the two intervention cycles.

Osteoporosis is an important identifiable risk factor for fragility fractures, which can be life altering for the geriatric population. It's identification and treatment has potential to lead to reduced burden of disease and reduced financial cost to the NHS in the future.

1. National osteoporosis guideline group, Section 2: Introduction to osteoporosis and fragility fractures (online). Available at: https://www.nogg.org.uk/full-guideline/section-2-introduction-osteoporo…
2. Osteoporosis - prevention of fragility fractures. Available at: https://cks.nice.org.uk/topics/osteoporosis-prevention-of-fragility-fra…