30 Aug 2018 | Reducing Harm from Falls
Authors of the newly released 2018 annual report of the Australian and New Zealand Hip Fracture Registry (ANZHFR) are calling for hospitals to make osteoporosis plans a priority for patients leaving hospital after a hip fracture.
Minimal trauma fractures are relatively common in people aged 50 and over. Among New Zealanders in this age group, it is estimated that one in three women and at least one in five men will experience a minimal trauma fracture.
Treatment for osteoporosis is key to reducing minimal trauma factures. However, data from the report shows only 25 percent of patients in New Zealand who undergo surgery leave hospital on active treatment for osteoporosis and only 24 percent of hospitals provide individualised written information on prevention of future falls and fractures.
Commenting on the report, Professor Jaqueline Close, geriatrician and co-chair of the ANZHFR, said that, while the data showed an improvement over last year’s report, New Zealand and Australia were still significantly behind other countries in closing the osteoporosis care gap.
‘There are huge opportunities to further improve hip fracture care, including the prevention of future falls and fractures. Strong evidence exists to support treatment of osteoporosis in this population yet all too frequently we fail to offer treatments which can impact on people’s lives,’ said Professor Close.
‘Hospitals need to work towards closing the care gap to ensure hip fracture patients go home with an individualised care plan designed to prevent future fractures.
‘General practitioners and other medical specialists also play a critical role in ensuring that bone health is addressed and that treatments are offered on an ongoing basis for our older New Zealanders unfortunate enough to break a bone from a fall.’
Although the rate of low trauma hip fractures has decreased over time, the actual number of fractures continues to increase due to the rising number of older people.
‘Our goal is to highlight the current gaps in care and work with hospitals across New Zealand and Australia to increase the uptake of proven, evidence-based treatments,’ said Dr Roger Harris, clinical lead for the hip fracture registry in New Zealand.
‘We also need to work in partnership with general practitioners who have a key role in managing chronic diseases such as osteoporosis.’
In New Zealand, the Live Stronger for Longer initiative is a multi-sector, system-wide response to the threat that falls and fractures present to older people.
As well as the hip fracture registry, a key focus of the initiative is the implementation of fracture liaison services (FLS).
The purpose of FLS is to ensure that all people who sustain fractures caused by osteoporosis undergo bone health assessment, receive osteoporosis treatment where needed and are referred to strength and balance programmes to prevent future falls.
Since a major investment by the Accident Compensation Corporation (ACC) in 2016, and considerable local investment from district health boards, access to FLS across New Zealand has improved dramatically.
‘FLS are internationally recognised as the best model of care to ensure we do our best to make the first osteoporotic fracture the last,’ said Christine Gill, executive director of Osteoporosis New Zealand.
‘As of August 2018, New Zealand has in fact become the first country in the world to provide universal access to FLS. With FLS teams working hard across the country to ensure every fracture patient receives the care that they need, a significant improvement in the management of osteoporosis after hip fracture should be evident in next year’s ANZHFR report.’