Brake the Break: The first community based partnership providing an Osteoporotic Refracture Prevention Service in New South Wales

Abstract

Background: There is strong evidence indicating the risk of refracture following an osteoporotic or minimal trauma fracture (MTF) is high. However, multiple national and international studies have highlighted the low rates of screening for bone fragility and treatment initiation among people presenting with MTF. Against this background and in response to the South Eastern Sydney _Local Health District (SESLHD) Falls Injury Prevention Plan 2013-2018_, Brake the Break (BtB), a community based partnership providing the first osteoporotic refracture prevention (ORP) service in metropolitan New South Wales (NSW) was established in May 2014. This service provides a significant addition to traditional referral pathways for these patients. The BtB service aims to reduce refractures in this patient cohort with MTF. The objectives are to increase the level of early identification and initiation of treatment in patients with osteoporosis. Method/Design: The BtB service, available to residents of the St George local government area of South Eastern Sydney, is based on the NSW Agency of Clinical Innovation Model of Care for Osteoporotic Refracture Prevention. A dedicated fracture liaison coordinator who identifies eligible patients and has responsibility for case management is central to this model. Identification of patients aged over 50 years with a recent MTF occurs via the Emergency Department (ED) admission records of St George Hospital, a major tertiary teaching hospital or through primary health care providers in SESLHD. Eligible patients are those who presented to the St George Hospital Emergency Department, primary health care providers and other health and community services. The Service is offered at two locations. The community based model of care, integrates the District's population health and World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. Discussion: This project aims to assess the efficacy of an integrated community based Osteoporosis Refracture Prevention. Preliminary outcome data will be presented.