Document resource
Background Steroid-induced osteoporosis is underestimated and undertreated. Rapid bone loss occurs early with increased fracture risk at 3-6 months. The aim of the audit was to evaluate bone health protection among inpatients on a tertiary neurology ward.Methods We reviewed the notes retrospectively for 20 patients who had an admission between October – December 2023 and were on ≥7.5mg prednisolone or its equivalent for ≥3 months. We collected data on demographics and assessed adherence with national guidelines for investigations and management of steroid-induced osteoporosis.Results Average age was 57 years old; 80% were >50. Male:Female ratio was 11:9. 80% were non-elective admissions with an average admission of 61 days. Majority (65%) had myasthenia gravis, neuromyelitis optica, chronic inflammatory demyelinating polyneuropathy or autoimmune encephalitis. 65% were newly initiated on steroids. All patients had routine osteoporosis investigation bloods except for thyroid function (35%) and vitamin D (30%). 5% had an inpatient DEXA. Only 4 patients were started on bisphosphonates during admission.Discussion We have identified areas for improvement in management of bone health in this patient group, highlighting the need for early investigation and initiation of bisphosphonates to prevent steroid-induced osteoporosis. Next steps include education and development of a standard operating protocol locally.edwinbarnes@hotmail.co.uk