title: Suboptimal bone protection in geriatric inpatients and effect of a simple educational and mnemonic strategy.
abstract: OBJECTIVE
  Osteoporosis is underdiagnosed and undertreated in Australia, especially in hospitalised patients. We aimed to improve bone health management in geriatric inpatients by introducing a mnemonic into discharge summaries.
  
  
  METHODS
  A retrospective review of patients discharged from our geriatric unit was performed before and after intervention. Outcomes assessed were as follows: vitamin D measurement, bone protection medication and communication to general practitioners.
  
  
  RESULTS
  Sixty-one patients were included in the initial audit, and 82 in the reaudit. There was an increase in measurement of vitamin D levels (86.6% vs 57.4%, P < 0.001) and in the communication to the general practitioner (84.7% vs 28.6%, P < 0.001). Patients in the reaudit were more likely to have vitamin D initiated or increased (43.0% vs 7.4%, P = 0.001) and to have antiresorptive therapy commenced (9.8% vs 0%, P = 0.01).
  
  
  CONCLUSIONS
  The introduction of simple education and mnemonic strategy has shown significant improvement in the assessment and management of bone health in at-risk patients.
authors.affiliation: Department of Geriatric Medicine, St Vincent's Hospital, Sydney, NSW, Australia. taylorarndtscott@gmail.com.
authors.forename: Taylor Arndt
authors.initials: TA
authors.lastname: Scott
authors.affiliation: Department of Geriatric Medicine, St Vincent's Hospital, Sydney, NSW, Australia.
authors.forename: Alexander
authors.initials: A
authors.lastname: Beveridge
authors.affiliation: Department of Geriatric Medicine, St Vincent's Hospital, Sydney, NSW, Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Ní Chrónín
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D057189:Checklist; D019587:Dietary Supplements; D005260:Female; D058005:General Practitioners; D005853:Geriatrics; D006801:Humans; D007297:Inpatients; D033183:Interdisciplinary Communication; D008297:Male; D008485:Medical Audit; D009517:New South Wales; D010024:Osteoporosis / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D010348:Patient Care Team; D063886:Patient Discharge Summaries; D017010:Reminder Systems; D012189:Retrospective Studies; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D014807:Vitamin D
keywords: health care; osteoporosis; osteoporotic fractures; patient discharge summaries; quality assurance; vitamin D