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Abstract
Osteoporotic fractures are a significant global public health concern, particularly in aging populations. They contribute to substantial morbidity, mortality, and healthcare costs, with over 300,000 fragility fractures annually in the UK, costing approximately £4.4 billion. Hip fractures are the most severe, with a one-year mortality rate of 20–30%. Effective secondary prevention strategies are essential to reduce the burden on healthcare systems.
Zoledronate, a third-generation bisphosphonate, effectively reduces recurrent fracture risk, improves bone mineral density, and lowers mortality, with the advantage of annual dosing for better adherence.
This quality improvement initiative was aimed to enhance secondary prevention through a local protocol promoting intravenous (IV) zoledronate post-hip fracture, in line with the National Osteoporosis Guideline Group (NOGG). Retrospective analysis of 64 patients (mean age 73 years) revealed a significant increase in IV zoledronate prescriptions from 14% to 61% after protocol implementation.
This study demonstrates that local protocols, supported by multidisciplinary team (MDT) education and tools such as Fracture Liaison Services (FLS) and the National Hip Fracture Database (NHFD), have improved osteoporosis management across NHS hospitals. However, challenges persist, including limited FLS coverage, suboptimal treatment adherence, and resource constraints. Addressing these barriers is critical to optimising care for elderly patients at risk of recurrent fractures.
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