Performance of a preventive care programme for osteoporosis in primary care settings in Singapore during the COVID-19 pandemic

Chin Kwang Chong, Wei Ting Chua, Susie Ling Yii Wong, T. Y. Tham
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Abstract

The Agency for Care Effectiveness of Singapore has advised primary care physicians to use osteoporosis screening tools to risk-stratify patients in the primary care setting. This paper aims to report the uptake of a “Predict and Prevent” workflow for osteoporosis using risk scoring and BMD measurement in patients with chronic diseases seen in a network of primary care clinics in Singapore from 2020 to 2021. A “Predict and Prevent” osteoporosis preventive care programme was implemented at a network of 11 primary care clinics. The programme included all adult patients that consulted at the clinic for a chronic condition. OSTA score was computed for each patient. All patients who consented to further fracture risk screening underwent FRAX scoring. Female patients with a high-risk OSTA score and females with diabetes with intermediate-risk OSTA score (per protocol), or those with high-risk FRAX score were recommended to undergo BMD measurement. Of the 6,332 adult patients with chronic diseases without baseline osteoporosis seen in the various clinics, 81.1% underwent OSTA scoring; 28.1% were intermediate risk and 7.0% were high risk. Among the per-protocol population ( n = 531), 38 (7.1%) underwent BMD testing. FRAX scoring (without BMD) was done on 939 patients (17.3%); 31.5% had a high hip fracture risk. Only 14 patients had FRAX with BMD; 57.1% had a high hip fracture risk. A “Predict and Prevent” workflow could be implemented to screen, detect and potentially treat patients at high risk of osteoporosis. The rate of BMD measurement is low and needs to be improved.
在 COVID-19 大流行期间,新加坡基层医疗机构骨质疏松症预防保健计划的执行情况
新加坡护理效果局建议初级保健医生在初级保健环境中使用骨质疏松症筛查工具对患者进行风险分级。本文旨在报告 2020 年至 2021 年期间,新加坡初级保健诊所网络采用风险评分和 BMD 测量方法对慢性病患者进行骨质疏松症 "预测和预防 "工作流程的采用情况。由 11 家初级保健诊所组成的网络实施了 "预测和预防 "骨质疏松症预防保健计划。该计划包括所有到诊所就诊的慢性病成年患者。为每位患者计算 OSTA 分数。所有同意接受进一步骨折风险筛查的患者都接受了 FRAX 评分。建议具有高风险 OSTA 评分的女性患者、具有中度风险 OSTA 评分的女性糖尿病患者(根据协议)或具有高风险 FRAX 评分的患者进行 BMD 测量。在各诊所就诊的 6332 名无基线骨质疏松症的成年慢性病患者中,81.1% 接受了 OSTA 评分;28.1% 为中危,7.0% 为高危。在按协议人群(531 人)中,38 人(7.1%)接受了 BMD 检测。939名患者(17.3%)进行了FRAX评分(无BMD);31.5%的患者髋部骨折风险较高。只有 14 名患者进行了带有 BMD 的 FRAX 评分;57.1% 的患者髋部骨折风险较高。可以采用 "预测和预防 "工作流程来筛查、检测和治疗骨质疏松症高风险患者。骨密度测量率较低,需要改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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