Hip Fracture - Quality Statement 14: Osteoporosis Management

Resources Quality Statements Advisory Committee About

Osteoporosis Management

While in hospital, patients with hip fracture undergo an osteoporosis assessment from a clinician with osteoporosis expertise and, when appropriate, are offered pharmacologic therapy for osteoporosis.

Background

As people age, the incidence of fragility fractures increases, owing to the higher incidence of osteoporosis in older populations. Treatment for osteoporosis leads to a reduction in re-fractures and mortality and a decreased rate of new fractures. All patients with fragility hip fractures are at high risk for future fractures, and pharmacologic intervention should be offered to all patients while in hospital, subject to contraindications. Bone mineral density testing to monitor treatment efficacy should be considered in those who accept osteoporosis treatment.

What This Quality Statement Means

For Patients

While you are in the hospital, a health care professional should assess you for osteoporosis (which causes bones to become brittle) and offer you the appropriate medication to help your bones be as healthy as possible.

For Clinicians

While your patient is still in hospital recovering from surgery, perform an osteoporosis assessment, and offer an osteoporosis medication (e.g., a bisphosphonate or bisphosphonate derivative, monoclonal antibody, or parathyroid hormone analog) unless they are already on osteoporosis medication or such medications are contraindicated.

For Health Services

Ensure that systems, processes, and resources are in place to allow all postoperative hip fracture patients to access a clinician with osteoporosis expertise who is qualified to perform osteoporosis assessments and prescribe osteoporosis medications.

Quality Indicators

Process Indicators

Percentage of hip fracture patients who receive an osteoporosis assessment from a clinician with osteoporosis expertise

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture
Numerator: number of people in the denominator who receive an osteoporosis assessment from a clinician with osteoporosis expertise
Data source: local data collection

Note: Patients with a fragility hip fracture who are already on osteoporosis medications or for whom osteoporosis medications are contraindicated are excluded.

Percentage of hip fracture patients who are diagnosed with osteoporosis and started on an osteoporosis medication (e.g., a bisphosphonate or bisphosphonate derivative, monoclonal antibody, or parathyroid hormone analog) while in hospital

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture who are diagnosed with osteoporosis
Numerator: number of people in the denominator who are started on osteoporosis medications while in hospital
Data source: local data collection

Note: Patients for whom osteoporosis medications are contraindicated are excluded.

Evidence to Improve Care