3184 IV Zoledronic acid post-discharge care for patients in the trauma ward, Craigavon Area Hospital

Abstract Introduction Following the publication of ‘Call to action: A Five nations consensus on the use of intravenous zoledronate after hip fracture,’ Craigavon Area Hospital began offering IV Zoledronic acid (IV Zol) to patients with a fragility neck of femur (NOF) fracture. However, the administration of IV Zol is based on the bone health assessment, vitamin D level, and requires ongoing post-discharge care. An oral bisphosphonate should be started one year after IV Zol administration. This study aimed to analyse whether discharges from Craigavon Area Hospital following a NOF fracture had clear instructions for post-discharge care. Method The discharge letters of patients with a NOF fracture from the Trauma Ward over six weeks were assessed and subdivided into three groups. A (Bone health, IV Zoledronic acid and post-discharge instructions), B (Bone health and IV Zoledronic acid mentioned but no post-discharge instructions given) and C (Bone health, IV Zoledronic acid and post-discharge instructions not mentioned). These groups were then analysed for potential interventions to improve future discharge letters. Discussion Only 38% (16) of the 42 discharge letters were included in group A and 37.5% contained ambiguous instructions. There were 13 discharge letters in groups B and C of which 15% and 38% were discharged outside of normal working hours respectively. The evidence suggests that standardised wording for discharge letters in patients with fragility NOF fractures and visible posters by the doctor’s computers may increase the proportion of patients in group A and thus improve patient care. Conclusion This study has highlighted the importance of adequate post-discharge care for patients who have received IV Zol. Unfortunately, many discharges did not mention the necessary information for GPs so proposals were made to improve ongoing care. This will be reassessed in March 2025.