SAT-798 Stronger Bones For A Stronger Life: Implementing Bone Health

Abstract Disclosure: H. Marasandra Ramesh: None. R. Subramani: None. N. Tara: None. M. Anwar: None. J.V. Pamula: None. Background: Osteoporosis is a systemic skeletal disorder marked by decreased bone density and deterioration of bone microarchitecture, increasing the risk of fractures. The World Health Organization defines osteoporosis as a T-score ≤ -2.5 at the hip or spine. Routine DEXA screening is recommended for all postmenopausal women over 65 years of age, and for men with risk factors per the U.S. Preventive Services Task Force (USPSTF) guidelines. Bisphosphonates remain the first-line treatment. This quality improvement (QI) project aimed to enhance osteoporosis management within an internal medicine clinic at Guthrie Robert Packer Hospital, Sayre. Objectives: The primary objective was to improve the rate of further workup and appropriate initiation of anti-resorptive therapy in patients diagnosed with osteoporosis, with endocrinology referral as needed, targeting a ≥2.5% increase. The secondary goal was to boost osteoporosis screening rates by ≥2.5% using DEXA and promote education on lifestyle modifications to reduce fracture risk. Study design: We implemented a multi-faceted intervention that included a physician in-reach workflow to identify and notify primary care providers of patients needing treatment. Internal medicine residents received targeted education on osteoporosis management. A standardized bone health protocol was introduced, outlining necessary pre-treatment laboratory evaluations, including serum calcium, vitamin D, creatinine, TSH, and additional testing to identify secondary causes (e.g., vitamin D deficiency, hyperparathyroidism, celiac disease, hyperthyroidism, multiple myeloma, Cushing’s syndrome, idiopathic hypercalciuria). Results: Pre-intervention DEXA screening rates were 43.4% (resident panel), 47.4% (attending panel), and 47.1% (overall). Post-intervention rates rose to 45.9%, 49.3%, and 48.5%, respectively. The resident panel achieved the targeted 2.5% increase in screening. Treatment initiation rates improved from 74.5% to 78.1% in the resident panel (a 3.6% increase), while rates for the attending and overall panels remained relatively stable. Among the resident panel, 144 of 314 patients were screened and 58 of 76 diagnosed were treated. Conclusion: This QI initiative demonstrated that physician education, targeted outreach through care gap identification in the electronic medical record, and standardized workflow can significantly improve osteoporosis screening and treatment rates. These strategies are practical and reproducible for enhancing bone health care delivery in internal medicine setting. Presentation: Saturday, July 12, 2025