AB1004 Osteoporosis screening in a tertiary rheumatoid arthritis clinic. who's screening now?. (12th June 2018)

• Record Type: Journal Article
• Authors: Kyi, L.; Kovitwanichkanont, T.; Wang, D.; Walpola, N.; Raghunath, S.; Pignataro, S.; Morton, S.; Leech, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 1622
• Page End: 1622
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.5217
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Osteoporosis is a complication of rheumatoid arthritis (RA) due to inflammatory disease and treatment with glucocorticoids 1 . Screening and management of osteoporosis (OP) is shared amongst General Practitioners (GP) together with subspecialists including rheumatologists 2 . Objectives: To assess the adequacy of osteoporosis screening in a tertiary RA clinic in Melbourne, and to determine where most screening is occurring. Methods: A cross-sectional study of patients at a tertiary RA clinic was undertaken. Osteoporosis screening, therapy and related factors were evaluated. This was compared to best practice screening ACR/GIOP guidelines. Results: 116 RA patients, 66% female (median age 58 years) were Included. OP screening occurred in 61.2% of patients with 40.5% and 20.7% performed by their rheumatologist and by the GPs respectively. The remainder 38.8% of patients recalled no recent screening. 36.2% of patients were taking prednisolone, while 74% reported prior exposure. 58.6% of patients had prednisolone for over 3 months. Calcium or vitamin D supplementation was noted in 62% of the population. 21.6% reported a history of minimal trauma fracture and alarmingly only 10% reported currently taking anti-resorptive therapy. 47% of patients had a DEXA scan performed within the last 3 years. Of the 53% that did not have a recent DEXA scan, three quarters had indications for osteoporosis screening based on the 2010 ACR/GIOP guidelines. 35 patients had indications based on age, 11 patients based on glucocorticoid exposure and 1 patient based on history of minimal trauma fracture. Conclusions: One third of at-risk patients in this sub-cohort are not screened for osteoporosis. More patients are currently screened for osteoporosis by their rheumatologist than their GPs. Underscreening and treatment of osteoporosis in this clinic could be addressed by clearer GP-rheumatologist shared treatment model. References: [1] Lane NE, Lukert B. The science and therapy of glucocorticoid induced bone loss. Endocrinol Metab Clin North Am1998;27: 465–83. [2] The Royal Australian College of General Practitioners. Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men. 1st edn. South Melbourne, Vic: RACGP, 2010. Disclosure of Interest: None declared