Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

A quality improvement project to increase treatment rates of osteoporosis in general practice

Patrick Bolton A * , Markus Seibel B , Daniel Moses C , Michael Moore D and Brendan Goodger E
+ Author Affiliations
- Author Affiliations

A Complex Care Physician Randwick Hospitals Campus and Centre for Primary Health Care and Equity, UNSW, NSW, Australia.

B Concord Repatriation General Hospital and Concord Medical School, The University of Sydney, Sydney, NSW, Australia.

C Graduate School of Biomedical Engineering, UNSW, NSW, Australia.

D General Practitioner, Hornsby, NSW, Australia.

E Central Eastern and Southern Primary Health Network, Randwick, NSW, Australia.


Australian Health Review https://doi.org/10.1071/AH24214
Submitted: 5 August 2024  Accepted: 26 September 2024  Published: 17 October 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

This study tests a model to improve the management of patients with an osteoporotic fracture.

Methods

Patients with fractures potentially due to osteoporosis were identified from imaging reports using computerised near natural language processing. A coordinator notified the referring GP about the finding and provided follow-up to remind GPs of the need for management. This provided an opportunity to assess action taken by the GP.

Results

Near natural language processing efficiently detected fractures in patients at risk of osteoporosis. GPs reported that they are managing osteoporosis in over 40% of patients identified. Notification of GPs coincided with a small increase in osteoporosis management.

Conclusion

Information technology can identify patient populations with clinically important risks such as osteoporosis. Methods to engage GPs to optimally address this risk have yet to be developed.

Keywords: general practice/primary care, machine learning, osteoprosis, prevention.

References

Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. J Contin Educ Nurs 2015; 46(11): 501-7.
| Crossref | Google Scholar | PubMed |

Watts J, Abimanyi-Ochom J, Sanders K. Osteoporosis costing all Australians. A new burden of disease analysis – 2012 to 2022. Glebe, NSW: Osteoporosis Australia; 2012.

Center JR, Bliuc D, Nguyen TV, Eisman JA. Risk of subsequent fracture after low-trauma fracture in men and women. JAMA 2007; 297(4): 387-94.
| Crossref | Google Scholar | PubMed |

Milat F, Ebeling PR. Osteoporosis treatment: a missed opportunity. Med J Aust 2016; 205: 185-90.
| Crossref | Google Scholar | PubMed |

Ganda K, Puech M, Chen J, Speerin R, Bleasel J, Center J, Eisman JA, March L, Seibel MJ. Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int 2013; 24: 393-406.
| Crossref | Google Scholar | PubMed |

Cooper MS, Palmer AJ, Seibel MJ. Cost-effectiveness of the Concord Minimal Trauma Fracture Liaison service, a prospective, controlled fracture prevention study. Osteoporos Int 2012; 23(1): 97-107.
| Crossref | Google Scholar | PubMed |

Yong JH, Masucci L, Hoch JS, Sujic R, Beaton D. Cost-effectiveness of a fracture liaison service--a real-world evaluation after 6 years of service provision. Osteoporos Int 2016; 27(1): 231-40.
| Crossref | Google Scholar | PubMed |

Bolton P. A doctor’s duty to follow up preventable conditions: Young v Central Australian Aboriginal Congress: a bridge too far? North Territ LAW J 2012; 2(3): 154-75.
| Google Scholar |

O’Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard‐Jensen J, Kristoffersen DT, et al. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2007; 4: CD000409.
| Crossref | Google Scholar |

10  Florentinus SR, Heerdink ER, van Dijk L, Griens AMG, Groenewegen PP, Leufkens HG. Is new drug prescribing in primary care specialist induced? BMC Health Serv Res 2009; 9(1): 6.
| Crossref | Google Scholar | PubMed |

11  Blaker K, Wijewardene A, White E, Stokes G, Chong S, Ganda K, et al. Electronic search programs are effective in identifying patients with minimal trauma fractures. Osteoporos Int 2022; 3: 435-441.
| Crossref | Google Scholar |

12  The Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice. 9th edn. East Melbourne, Vic: RACGP; 2016. Available at https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Red%20Book/Guidelines-for-preventive-activities-in-general-practice.pdf [cited 8 April 2023].

13  Runciman WB, Hunt TD, Hannaford NA, Hibbert PD, Westbrook JI, Coiera EW, et al. CareTrack: assessing the appropriateness of health care delivery in Australia. Med J Aust 2012; 197(2): 100-5.
| Crossref | Google Scholar | PubMed |