Bone Health Improvement Protocol

Abstract

Introduction. Metabolic bone disease is a malady that causes
significant morbidity and mortality to a patient who has sustained
a fragility fracture. There is currently no protocol to
prevent secondary fragility fracture at our institution. The objective
of this study was to create an appropriate protocol for
implementing clinical pathways for physicians to diagnose and
treat osteoporosis and fragility fractures by educating patients.

Methods. A multidisciplinary team created an appropriate
protocol that could be implemented in an inpatient setting.
A thorough literature review was conducted to evaluate
potential barriers and efficacious methods of protocol design.

Results. A bone health improvement protocol was developed.
Any patient over the age of 50 who sustains a fracture from low
energy trauma, such as a fall from standing or less, should be
considered to place into this protocol. These patients received
education on metabolic bone disease, a prescription for high
dose vitamin D therapy, and laboratory testing to determine
the etiology of their metabolic bone disease. Continuity of care
of these patients with their primary care provider was provided
for further management of their metabolic bone disease and
evaluation of their disease after discharged from the hospital.

Conclusion. Comprehensive secondary prevention should consist
of osteoporosis assessment and treatment together with a
fall risk assessment. With this protocol, secondary fragility fractures
potentially could be prevented. KS J Med 2017;10(3):62-66.