A Break in Care: Investigating Gaps in Post-Fracture Osteoporosis Screening

Document Type

Conference Proceeding

Publication Date

3-6-2026

Publication Title

Am J Health Syst Pharm

Keywords

Pharmacology & Pharmacy

Abstract

Purpose: Osteoporosis is characterized by decreased bone density and deterioration of bone tissue, leading to increased bone fragility and higher risk of fracture. In the United States, approximately 10.2 million adults over 50 years old are affected. Fragility fractures are defined as fractures occurring in a setting of low-level trauma and are considered osteoporotic. Variability in guidelines and workflows may contribute to inconsistent screening practices among primary care providers, resulting in misalignment with recommended standards. The purpose of this study is to assess the prevalence of appropriate osteoporosis screening in patients who experienced a fragility fracture following emergency department (ED) presentation. Methods: This will be an IRB-approved, descriptive, retrospective, cross-sectional study to characterize osteoporosis screening utilization among patients with a history of fracture. We will identify patients aged ≥ 40 years who presented to the ED at Henry Ford Health System (HFHS) between August 2024 and August 2025 with a fragility fracture (defined as a fracture resulting from standing height or low trauma) using the Epic electronic health record. Patients who are pregnant, incarcerated, cognitively impaired, have non fragility fractures, or have a documented osteoporosis diagnosis at ED presentation will be excluded. The primary outcome is the incidence of appropriate osteoporosis screening by HFHS providers as evidenced by use of Dual-energy X-ray absorptiometry (DEXA) and Fracture Risk Assessment Tool (FRAX) within 3 months. Secondary outcomes will characterize screening appropriateness relative to guideline-recommended risk factors and screening tools. Data collected will include patient demographics, medications associated with osteoporosis, comorbidities, family history; menopausal status, and primary care follow-ups. Descriptive statistics will be utilized for data analysis. A sample of 100 patients is planned to allow meaningful description and analyses.

Volume

83

First Page

S807

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