Is systematic osteoporosis prevention and detection possible in a district hospital?
Osteoporosis demands systematic management for optimum use of resources. Guidelines from the Primary Care Rheumatology Society (PCRS) aim to improve its diagnosis and treatment. We identified all admissions over three months to a district general hospital of patients with fracture of femur, vertebra, or distal forearm and of women who underwent oophorectomy or hysterectomy. We audited their care using the criteria that the diagnosis and risk of osteoporosis should be recorded; that management should follow PCRS guidelines; and that this information should be communicated to general practitioners. An ideal standard of 100% compliance with these criteria was chosen. Overwhelmingly these audit criteria were not met, the only one that was met being the prescription of hormone replacement therapy after oophorectomy. Potential for prevention of 35% of hip and distal forearm fractures was identified, the commonest risk factor being long-term corticosteroid therapy. Identification of high risk
