FRAX® Utilisation in patients admitted following falls: a Baseline evaluation of current practice.

Compliance with Fracture risk assessment tool (FRAX®) assessment in patients presenting with falls and admitted via acute medical take: a baseline audit in a UK district general hospital

Background: Falls are a major risk factor for fragility fractures. The National Osteoporosis Guideline Group (NOGG) recommends fracture risk assessment using FRAX® in eligible patients; however, compliance with this recommendation in routine clinical practice is uncertain

Aim: To assess compliance with FRAX® fracture risk assessment in eligible patients admitted following falls.

Methods: A retrospective audit was conducted of patients admitted following falls over a three-week period (n=28). Electronic patient records were reviewed to determine whether FRAX® assessment had been documented during admission. Patients were assessed against predefined eligibility criteria for FRAX® assessment. Patients with active malignancy, those receiving bone-protective therapy, and patients receiving end-of-life care were excluded from the primary analysis.

Results: Of 28 patients identified, 15 met eligibility criteria following exclusions. FRAX® assessment was documented in 0/15 eligible patients (0%). No FRAX® assessments were documented among excluded patients.

Conclusion: FRAX® assessment was not documented in any eligible patient admitted following a fall. This represents a gap between guideline recommendations and clinical practice, with potential missed opportunities for fracture risk stratification and initiation of preventative interventions.

Next steps: Planned interventions include clinician education, incorporation of FRAX® prompts into admission documentation, and re-audit to assess the impact of these measures.

Reference: https://www.nogg.org.uk/full-guideline Kanis JA et al. FRAX® and the assessment of fracture probability in men and women from the UK. Osteoporos Int.