Aim: Despite the widely available tools for diagnosis and cost-effective medications to treat osteoporosis, suboptimal osteoporosis care or ‘treatment gap’ remains a public health concern. The aim of this study was to assess the patterns of anti-resorptive prescribing in post-neck of femur (NOF) fracture geriatric patients.
Methods: We identified all patients aged ≥65 years admitted to the orthogeriatric unit or geriatric rehabilitation ward across two metropolitan hospitals due to NOF fracture (International Classification of Disease-10 code S72.0) between 1/06/2023 and 31/12/2023. Data on demographics, medications taken prior to admission, any documented plans for anti-resorptive agent during hospital stay and the choice of treatment were extracted from the electronic health record.
Results: A total of 182 patients (64% female; mean age 88.4 years) were included. Anti-resorptive therapy was commenced on or prior to discharge from hospital in 36% (65/182) of patients. Of these, the most commonly initiated medication was denosumab (60/65, 92%). A further 29% (52/182) of patients had a documented plan for anti-resorptive treatment following discharge despite not being initiated in hospital and the remaining one-third (65/182; 36%) had no documented plan for treatment commencement.
Conclusion: The findings suggest the potential underuse of anti-resorptive agents in older adults post-NOF fracture. Further investigation is required to establish barriers to anti-resorptive prescribing and communication at transitions of care. Targeted interventions could include implementation of partnered pharmacist medication prescribing within the surgical division and the integration of electronic prompts for initiation and continuation of anti-resorptive therapy within the electronic discharge summary system.