Evaluation of current practice: compliance with osteoporosis clinical guidelines in an outpatient fracture clinic

Abstract

Better detection and management of osteoporosis will reduce unnecessary health expenditure. A number of high quality guidelines are available to support early detection and best practice management of osteoporosis in hospital settings. However, sustainable implementation of guidelines poses practical issues in terms of structure and processes in hospitals. This paper describes an investigation into guideline compliance in one large tertiary metropolitan hospital and discusses practical elements of guideline implementation. Given the evidence of poor practice across the two audit periods, we recommend that a coordinated clinical pathway be implemented in the fracture clinic, supported by a targeted and disciplinespecific training program. Small steps towards improving awareness and management of osteoporosis in patients presenting for the first time with non-trauma wrist fracture may well produce large cost savings by future fracture prevention.