RESEARCH ARTICLE
Improving Osteoporosis Management in Primary Care: An Audit of the Impact of a Community Based Fracture Liaison Nurse Tom Chan1*, Simon de Lusignan1☯, Alun Cooper2☯, Mary Elliott2☯ 1 Clinical Informatics, Department of Health Care Policy and Management, University of Surrey, Guildford, Surrey, United Kingdom, 2 Bridge Medical Centre, Three Bridges Road, Crawley, West Sussex, United Kingdom ☯ These authors contributed equally to this work. *
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Abstract OPEN ACCESS Citation: Chan T, de Lusignan S, Cooper A, Elliott M (2015) Improving Osteoporosis Management in Primary Care: An Audit of the Impact of a Community Based Fracture Liaison Nurse. PLoS ONE 10(8): e0132146. doi:10.1371/journal.pone.0132146
Background Osteoporosis and associated fragility fractures are a major health problem; they are more common in women over 50 years old. Fracture liaison nurses have been widely used in secondary care to promote the recognition of fragility fractures and to promote the use of bonesparing medication to reduce the risk of recurrent facture.
Editor: Robin Dore, David Geffen School of Medicine, UNITED STATES
Objective
Received: May 21, 2014
Audit the impact of a primary care based fracture liaison nurse on the detection of fragility fractures in people with osteoporosis and their treatment with a bone-sparing medication.
Accepted: June 10, 2015 Published: August 27, 2015
Method
Copyright: © 2015 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This audit took place in 12 GP practices using ‘before and after’ cross-sectional extractions of anonymised routine data. We report, for females 50–74 years and 75 years old, socioeconomic deprivation index, the prevalence of osteoporosis, recording of fragility fractures, dual-energy X-ray absorptiometry (DXA), smoking, and body-mass index (BMI) and use of appropriate bone-sparing medication. We used Altman’s test of independent proportions to compare before and after data.
Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: Crawley Practice Based Commissioning (PBC) group funded the audit.
Results
Competing Interests: TC have declared that no competing interests exist. AC’s practice participated in the audit and was a member of the Crawley PBC group. ME worked as fracture liaison nurse. SdeL have declared that no competing interests exist. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.
Recording of the diagnosis of osteoporosis increased from 1.5% to 1.7% (p = 0.059); the rate of DXA scans fell (1.8% to 1.4%; p = 0.002); recording of fractures and fragility fractures more than doubled (0.8% to 2.0%; p
