Authors: B J Edwards A D Bunta J Anderson A Bobb A Hahr K J O’Leary A Agulnek L Andruszyn K A Cameron M May N H Kazmers N Dillon D W Baker M V Williams
Publish Date: 2012/01/25
Volume: 23, Issue: 10, Pages: 2489-2498
Abstract
Osteoporosis is infrequently addressed during hospitalization for osteoporotic fractures An EMRbased intervention osteoporosis order set was developed with physician and patient input There was a trend toward greater calcium supplementation from July 2008 to April 2009 s = 0058 however use of antiresorptives 13 or discharge instructions for BMD testing and osteoporosis treatment 10 remained lowPhysicians reported that barriers to care comprised nonacute nature of osteoporosis belief that osteoporosis should be addressed by the PCP low awareness of recurrent fractures and radiographs with terms such as “compression deformity” “wedge deformity” or “vertebral height loss” which in their opinion were not clearly indicative of vertebral fractures An EMRbased intervention was developed with physician and patient input Over the evaluation period 295 fracture cases in individuals over the age of 50 years in the medicine floors were analyzed Mean age was 72 ± 11 years 74 were female Sites of fracture included hip n = 78 27 vertebral n = 87 30 lower extremity n = 61 21 upper extremity n = 43 15 and pelvis n = 26 9 There was no increase in documentation of osteoporosis in the medical record from pre to postEMR implementation p = 089 There was a trend toward greater calcium supplementation from July 2008 to April 2009 p = 0058 however use of antiresorptives 13 or discharge instructions for BMD testing and osteoporosis treatment 10 remained lowAn electronic medical record intervention without electronic reminders created with physician input achieves an increase in calcium supplementation but fails to increase diagnosis or treatment for osteoporosis at the time of hospitalization for a fragility fracture
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