TBA (17A184)

Audit: Osteoporosis Screening In a Cohort of COPD Outpatients

Author(s)

Una Lannin, James Hayes

Department(s)/Institutions

General Medicine Department, Respiratory Department

Introduction

Osteoporosis is a significant cause of morbidity and mortality in the Irish population (1). COPD is a risk factor for the development of osteoporosis both due to the underlying disease pathogenesis and the use of steroids.  It is recommended that all patients with a chronic illness, such as COPD, should undergo screening for osteoporosis (2). 

Aims/Background

The aim of this audit is to investigate the frequency of screening for osteoporosis in a group of Irish outpatients with COPD.   

Method

The COPD Outreach Programme in Cavan General Hospital enrols patients with COPD who have had at least one prior hospital admission. The patients are reviewed shortly after discharge and then on an as required basis. Data for each patient relating to disease severity, smoking status and previous DEXA scanning is collected and entered onto a database. Data was extracted from this database and analysed using SPSS for the purposes of this audit. A chart review was then performed to obtain results of DEXA scan. 

Results

89 subjects were included, 40 male and 49 female. The average age was 71.  50 identified as ex smokers, 20 as current smokers and 3 as lifelong non- smokers. 30 patients underwent screening for osteoporosis. 21 were found to have osteoporosis. FRAX score was note used to calculate fracture risk for any patient. 

Conclusions

This audit found that there is an inadequate level of screening for osteoporosis in patients with COPD. Greater awareness is required among health care professionals regarding the association between COPD and the development of osteoporosis and its related comorbidities. We recommend the implementation of a validated screening tool such as FRAX. The FRAX tool is used to estimate a patients fracture risk. Patients found to be at significant risk should undergo a DEXA scan. This tool should be applied on the initial visit and subsequent assessments determined by the results.

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