Improving Osteoporosis Screening in Parkinson's Disease and Related Conditions-Think FRAGILE

OBJECTIVES: Patients living with Parkinson's disease (PD) and related disorders are at increased risk of osteoporosis and fractures. However, bone health remains under-assessed in clinical practice. The aim of this study was to evaluate whether the FRAGILE tool that we previously developed improved osteoporosis screening and referral practices in a PD and related diseases clinic. METHODS: We performed an audit of 283 outpatient consultation letters evaluating the use of the FRAGILE tool for screening osteoporosis risk. RESULTS: Following implementation of the FRAGILE tool our referral rate for osteoporosis screening improved from 23% to 48% of at-risk patients. Specifically, marked improvements were seen in referrals for patients with osteopenia, falls and fractures, but factors such as osteoporosis-associated medications and medical comorbidities were still often overlooked. CONCLUSIONS: Osteoporosis screening referrals improved after introduction of the FRAGILE tool in clinical practice. Further efforts are required to address less overt risk factors.