Osteoporosis awareness protocol for patients with fragility fractures.
OBJECTIVE
To develop and implement a protocol that improves recognition of osteoporosis in patients with fragility fractures.


METHODS
The awareness protocol included 6 meetings with the clinical staff of the emergency department (ED) and the orthopedic department to discuss osteoporosis awareness, a poster placed in the ED triage and orthopedic residents' rooms, monthly verbal awareness reminders, and distribution of pocket-sized poster copies to the residents.


RESULTS
Two hundred ninety-one patients with fractures were admitted to Howard University Hospital from June 2005 - December 2005. Fractures were evident in 11% (n = 32). All were admitted from the ED. Of the patients with fractures, 81% were African American--62.5% were women with a mean age of 73.3 +/- 15.8 years; the mean age of the men, 59.3 +/- 14.9 years. The orthopedists requested an endocrine consult for 8 patients. Osteoporosis was evident in 25% of the fracture patients (n = 8). One of these patients was diagnosed on the basis of risk factors, thus 22% were diagnosed on the basis of dual-energy x-ray absorptiometry and pathological findings. As compared with a prior study, this is a significant increase (13%, p = .02) in the diagnostic rate at this institution. Bisphosphonates were prescribed for 3 of the 32 patients (9%) prior to discharge.


CONCLUSIONS
This pilot study presents an easy-to-execute awareness protocol that significantly improved the diagnosis of osteoporosis in a predominantly African American population with fractures. The diagnosis of osteoporosis may be enhanced by cooperative efforts among ED, orthopedics, endocrinology, and other disciplines.
Al-Dabagh
Hiba
H
Howard University Hospital, 2041 Georgia Ave, Washington, DC 20060, USA. mosul5@yahoo.com
Archer
Juanita
J
Newton
Marisha
M
Kwagyan
John
J
Nunlee-Bland
Gail
G
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D015984:Causality; D002985:Clinical Protocols; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D008403:Mass Screening; D008505:Medical Staff, Hospital / Q000193:education*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'