Oral Bisphosphonate Administration on a Hip Fracture Unit : Knowledge, Practice & Patient Experience Audit

INTRODUCTION

Oral bisphosphonates are widely prescribed for fracture prevention. Their efficacy is dependent on adherence to administration guidance. A British Geriatrics Society (BGS) review highlighted that incorrect administration provides minimal or no fracture protection, particularly in frail or hospitalised patients (1,2). Despite this, oral bisphosphonates are frequently prescribed or continued during inpatient admissions where correct administration may be challenging. Our aim was to assess multidisciplinary knowledge, local administration practice, and patient recall of administration of oral bisphosphonates, to determine whether these are being given in line with ROS guidance on the acute inpatient ward.

METHOD

This audit is currently in progress, using two approaches:

1. Staff Knowledge & Practice

An anonymous questionnaire has been distributed to all clinical staff involved in prescribing, administering or overseeing medications. The questionnaire assesses:

· Knowledge of correct administration according to ROS guidance

· Awareness that incorrect administration negates effectiveness

· Self-reported local practice and perceived barriers

· Confidence and training needs

2. Patient Recall Post-Administration

Following administration of oral bisphosphonates, inpatients are being asked a set of questions including how the medication was given (timing, fluid, posture) and what instructions they recall receiving.

Patient responses will be compared with ROS administration standards to assess real-world practice.

Data will be analysed descriptively.

RESULTS

This audit is expected to:

· Identify knowledge gaps within the MDT

· Highlight discrepancies between intended practice and patient reports

· Identify barriers specific to the inpatient environment

· Inform targeted education and prescribing decisions

CONCLUSIONS

Depending on findings, proposed interventions include:

· Multidisciplinary education sessions

· A ward-based bisphosphonate administration checklist

· Greater consideration of withholding oral bisphosphonates

REFERENCES

1. British Geriatrics Society (BGS) (2019) The care of patients with fragility fracture (Blue Book).

2. Royal Osteoporosis Society (ROS) (n.d.) Alendronic acid and Risedronate: drug treatment for osteoporosis.