title: Improving osteoporosis management following minimal trauma fracture in a regional setting: The Coffs Fracture Card Project.
abstract: OBJECTIVE
  To improve osteoporosis (OSP) management following minimal trauma fracture (MTF) with few additional resources.
  
  
  METHODS
  Population intervention with serial cross-sectional analysis.
  
  
  METHODS
  Regional setting involving primary care, base hospital and private hospital.
  
  
  METHODS
  Patients with MTF.
  
  
  METHODS
  A 'Fracture Card' prompting OSP management was provided to all patients post-MTF. Patients were encouraged to attend their general practitioner (GP) with this to discuss bone health issues. The 2-year intervention was supported by a public health education campaign.
  
  
  METHODS
  Number of (i) serum 25-OH vitamin D assays, (ii) dual-energy X-ray absorptiometry (DXA) scans, and (iii) new Pharmaceutical Benefits Scheme (PBS)-subsidised prescriptions for bone protective therapy (bisphosphonates, raloxifene, strontium, teriparatide, denosumab).
  
  
  RESULTS
  The number of serum 25-OH vitamin D assays ordered in Coffs Harbour increased from 329 ± 15 per month (July 2009-June 2010) to 568 ± 21 (July 2010-June 2012; P < 0.001). The number of DXA scans performed per month increased from 192 ± 14 (July 2009-June 2010) to 296 ± 12 (July 2010-June 2012; P < 0.001). There was no difference in the number of new PBS-subsidised prescriptions for bone protective therapy in the Coffs statistical subdivision over that time (176 ± 3.8 per month, July 2009-June 2010 versus 180 ± 3.5, July 2010-June 2012, P > 0.05).
  
  
  CONCLUSIONS
  The intervention was associated with an increased number of 25-OH vitamin D assays and DXA scans but not with more prescriptions for bone protective therapy. This suggests that a public health education campaign and provision of a 'prompt' for GPs was only partially successful at improving OSP management post-MTF. This has driven establishment of a Fracture Liaison Service.
authors.affiliation: Mid-North Coast Arthritis Clinic, Coffs Harbour, New South Wales, Australia.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Tulk
authors.forename: Pam
authors.initials: P
authors.lastname: Lane
authors.forename: Anne
authors.initials: A
authors.lastname: Gilbey
authors.forename: Helena
authors.initials: H
authors.lastname: Johnston
authors.forename: Karen
authors.initials: K
authors.lastname: Chia
authors.forename: Lee
authors.initials: L
authors.lastname: Mitchell
authors.forename: Hanish
authors.initials: H
authors.lastname: Bagga
authors.forename: Peter K K
authors.initials: PK
authors.lastname: Wong
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data*; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000628:therapy*; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010353:Patient Education as Topic; D014807:Vitamin D / Q000097:blood*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D
keywords: fracture; minimal trauma; osteoporosis; regional