Posters

Introduction Clinicians are regularly encouraged to make discussion and documentation of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) status a routine part of their assessment and care of older patients. However, patients, their families and clinicians often question whether a DNACPR decision may affect the attention paid to other aspects of patient care, or their access to interventions unrelated to CPR. We set out to directly test and address this question using a randomised controlled study of a clinical vignette. Methods We presented a clinical scenario of a deteriorating patient

Introduction: The very high-risk patients remain at a comparatively higher risk of sustaining a subsequent fracture following an initial fragility fracture, with the risk being greatest within the first 1-2 years. The current guidance advocates a “treat-to-target” strategy, recommending initiation of anabolic therapy followed by sequential antiresorptive treatment. The objective of this study was to quantify imminent fracture risk before and after commencing anabolic agents. Materials and Methods: We conducted a retrospective review of all patients who were commenced anabolic therapy between

Introduction: Osteoporosis affects approximately 3.5 million individuals in the UK, resulting in over 500,000 fragility fractures annually. An initial fracture significantly increases the risk of subsequent fractures, particularly in very high-risk patients. Current clinical guidelines advocate a "treat-to-target" strategy using ‘anabolic first’ for individuals at very high risk of fracture. The aim of this study is to develop and evaluate an innovative approach to improve system efficiency, timeliness and prudent delivery of anabolic osteoporosis drugs. Methods: Specialist anabolic

Introduction: Dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis; however, due to limited capacity it is not available to all patients with fragility fractures. A multidimensional quality improvement project, using the Plan–Do–Study–Act (PDSA) model, led to the implementation of several initiatives between 2022 and 2023. These included increasing scanning capacity, vetting repeat DXA requests, upskilling the bone health team, and strengthening partnerships with primary care. The objective of this study is to assess the sustainability of these initiatives in

Introduction Deprescribing is central to frailty care. We evaluated whether a Frailty Enhanced Specialist Service (FESS) was associated with higher deprescribing rates. Method Single-centre retrospective observational study using routinely collected data from inpatients admitted from care homes before the existence of FESS (January; n=78) and, post-implementation, to FESS or non-FESS wards in June (FESS n=54; non-FESS n=37) and December (FESS n=32; non-FESS n=49). We recorded total regular medicines and Anticholinergic Cognitive Burden (ACB) scores at admission and discharge, plus age, sex

Enhancing assessment and continence care in a community hospital setting: A quality improvement project. Introduction: It was noted that continence was frequently not addressed prior to transfer to a community hospital setting. The project aimed to recognise and offer opportunities for improved continence care. Method: Patients were screened for continence problems through comprehensive geriatric assessment on arrival at a community hospital from acute settings. The first cycle identified whether continence assessment was considered on arrival at our community site. Subsequent cycles improved

Introduction: Chronic Kidney Disease (CKD) is associated with abnormal bone metabolism and increased fragility fracture risk. However, many older people often have both CKD and osteoporosis, go undiagnosed and untreated. The objective of this study is to measure prevalence of CKD among patients presenting with fragility fractures. Methods: 3839 fragility fracture patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) between January 2022 and December 2023 were reviewed retrospectively. 1325 patients’ fragility fracture were excluded due to non-availability of estimated glomerular

Introduction: Pelvic fractures are a common fragility fracture but often under recognised. There is a wide range of incidence 6.9-78.6/100,000/year being reported in the UK. The objective of this study was to measure incidence of pelvic fracture and re-fracture rate for the population of Gwent (592,000). Methods: A retrospective service evaluation of all fragility fracture patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) between January 2022 and December 2025 was completed. Pelvic fracture cases were extracted from the FLS-DB for analysis. Data were analysed to describe patient

Introduction: Chronic Kidney Disease (CKD) affects 5-10% of the world population and is associated with increased fragility fracture risk and mortality. The objective of this study is to measure impact of CKD stage on one-year mortality in fragility fracture patients. Methods: 5320 fragility fracture patients seen by Aneurin Bevan Fracture Liaison Service (AB-FLS) between January 2022 and June 2024 were reviewed retrospectively. 1718 patients’ fragility fracture were excluded due to non-availability of estimated glomerular filtration rate (eGFR). CKD stages were classified based on eGFR (mL

Background Sialorrhoea is a common non-motor complication of Parkinson's disease (PD), but its significance beyond symptom burden remains under-recognised. We hypothesised that referral for sialorrhoea represents a late disease milestone associated with advanced disease stage and may serve as a surrogate marker of frailty and mortality risk. Methods We conducted a retrospective cohort analysis of patients referred to the Parkinson's sialorrhoea service in Cardiff and Vale between May 2021 and June 2025. Demographics, Hoehn and Yahr (H+Y) stage, age-stratified outcomes, referral timelines, and

Herpes zoster (HZ) results from the reactivation of latent varicella zoster virus, acquired earlier in life. The risk of post-herpetic neuralgia (PHN), the most frequent HZ complication, increases with age. In 2024, the Joint Committee on Vaccination and Immunisation extended its recommendation of the recombinant zoster vaccine (RZV) for inclusion in the United Kingdom (UK) National Immunisation Programme to adults aged ≥80 years. In this study, we evaluate the potential public health impact of RZV introduction in adults aged ≥80 years. The ZOster ecoNomic Analysis (ZONA) model was adapted to

Introduction Parkinson’s disease (PD) affects approximately 145,000 individuals in the United Kingdom, and its prevalence is projected to increase by 20% by 2025.Parkinson disease medications are time-critical, and delays in prescribing or administration can lead to worse clinical outcomes. This Quality Improvement Project (QIP) was undertaken to evaluate the accuracy of Parkinson’s disease (PD) medication prescriptions on admission to the University Hospital Lewisham (UHL) Elderly Care Wards Method A retrospective review of patient records and pharmacy medication histories was conducted using

Introduction: Older adults are the main users of acute hospital medical care, however the hospital environment poses well-documented risks, particularly for older adults living with frailty. Hospital-at-homes (HaHs), also known as virtual wards, provide acute multidisciplinary healthcare at home for acute medical conditions. However, little is known about current operational models and clinical activity. This study aimed to describe current UK HaH services and their clinical activity on a national scale. Methods: A national cross-sectional survey of UK HaHs conducted in April 2025, describing

Introduction: Patients with high Clinical Frailty Scale (CFS) scores are experiencing substantial radiological investigations in their final months of life. We quantified imaging use in the last six months of life, examined associations between age, CFS, and imaging frequency, and compared patients with and without an anticipatory clinical management plan (ACMP). Methods: Retrospective cohort study (n=94) of randomly selected care home residents with CFS 5–9 admitted to a District General Hospital between January and December 2024. All had died before inclusion. Imaging data were retrieved

Background Surgery is the curative-intent management of colorectal cancer (CRC). Chronological age inadequately captures perioperative vulnerability. Frailty is associated with worse perioperative morbidity, mortality, and longer hospitalization. Hospital Frailty Risk Score (HFRS) is validated for risk-stratifying hospitalized patients. Methods A total of 47,190 admissions with age ≥65 years and CRC who underwent colorectal surgery in 2022 in the USA were extracted from the national inpatient sample database. Admissions were categorized into 6 admission groups based on age-groups (65-75, 75-85

Introduction: Constipation is common amongst hospitalised older adults and is associated with increased length of stay, delirium and falls, yet bowel hygiene is often under-recognised and poorly documented. On the Ageing and Complex Medicine (ACM) ward at Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, multiple safety concerns were identified, including difficulty locating the bowel chart in the electronic record, inconsistent documentation and patients going more than five days without a bowel opening without appropriate escalation. Methods: A baseline review

Introduction Older adults with hip fractures have high mortality, loss of independence and a substantial burden of depression and anxiety, yet mood and alcohol use are rarely screened systematically in trauma pathways. We examined whether alcohol risk was associated with post-fracture psychological distress and hospital length of stay (LOS) in a Silver Trauma service, to inform an integrated screening pathway. Methods We undertook a retrospective cross-sectional review of adults aged ≥50 years admitted with hip fracture to the Bristol Royal Infirmary between January and April 2023, using

Introduction Frailty Same Day Emergency Care (FSDEC) is an approach designed to provide rapid assessment, diagnosis, and treatment for older adults with frailty without requiring hospital admission. By reducing unnecessary inpatient stays, Frailty SDEC alleviates pressure on acute beds, improves patient flow, and enhances overall system efficiency. We explored the efficacy of this across 3 acute hospitals. Method A retrospective review of FSDEC activity was conducted from June 2024 for 1 year, across three sites in Surrey Heartlands ICS: ASPH, RSCH, and SaSH (which launched its service in

Introduction Hyponatraemia is a prevalent laboratory abnormality in older patients associated with falls, delirium, and prolonged hospital admissions. Despite established guidance, initial assessment is frequently incomplete, with premature endocrinology referrals made before adequate evaluation. This project aimed to improve the quality of hyponatraemia assessments, initial management, and referrals within our geriatric department. Methodology A two-cycle quality improvement project was conducted using a Plan–Do–Study–Act (PDSA) framework. Baseline audit data (Cycle 1, n=50) identified

Introduction: Evidence suggests older patients and their carers who attend urgent care settings are unaware they can self-refer to community and charity services for ongoing support. Aim: To use the domains of the Comprehensive Geriatric Assessment (CGA) to design a holistic patient resource that signposts patients, relatives and carers to different services, thereby enabling them to age well or manage changes in ability. Method: The Quality Improvement Project received Trust governance approval (Ulysses no. 8911). A literature review was undertaken to establish whether there were existing