Integration of a vertebral fracture identification service into a fracture liaison service: a quality improvement project.
Terence OngR CopelandC N ThiamG Cerda MasL MarshallO SahotaPublished in: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (2020)
In total, 4461 patients with CT scans were retrieved over the 3-month period of which 850 patients had vertebra fractures identified (19.1%). Only 49% had the fractures described on hospital radiology report. On average, 61 patients were identified each week with a median of two fractures. Thirty-six percent were identified by the FLS for further action and recommendations were made to either primary care or the community osteoporosis team within 3 months of fracture detection. Of the 64% not identified for further action, almost half was because the CT was part of cancer assessment or treatment. The remaining were due to a combination of only ≤ 2 mild fractures; already known to a bone health specialist; in the terminal stages of any chronic illness; significant dependency for activities of daily living; or a life expectancy of less than 12 months CONCLUSION: It was feasible to integrate a commercial vertebral fracture identification service into the daily working of a FLS. There was a significant increase in workload which needs to be considered by any future FLS planning to incorporate such a service into their clinical practice.
Keyphrases
- healthcare
- mental health
- end stage renal disease
- primary care
- bone mineral density
- computed tomography
- clinical practice
- newly diagnosed
- chronic kidney disease
- prognostic factors
- peritoneal dialysis
- public health
- physical activity
- magnetic resonance imaging
- palliative care
- randomized controlled trial
- contrast enhanced
- squamous cell carcinoma
- postmenopausal women
- hip fracture
- magnetic resonance
- emergency department
- patient reported outcomes
- machine learning
- clinical trial
- study protocol
- risk assessment
- label free
- smoking cessation
- human health