15 research outputs found
In search of the ideal basal insulin: Does the new-generation ultra-long-acting insulin, degludec, provide the answer?
published_or_final_versio
The clinical significance of aldosterone synthase deficiency: report of a novel mutation in the CYP11B2 gene
published_or_final_versio
Hypoadiponectinemia As an Independent Predictor for the Progression of Carotid Atherosclerosis: A 5-Year Prospective Study
published_or_final_versio
Adiponectin gene variant +276G>T independently predicts incident coronary heart disease in men: a 16-year prospective study
Adiponectin gene variant +276G>T independently predicts incident coronary heart disease in men: a 16-year prospective studypublished_or_final_versio
Obesity as the common soil of non-alcoholic fatty liver disease and diabetes: Role of adipokines
link_to_OA_fulltex
Congenital adrenal hyperplasia presenting as a large adrenal incidentaloma in an elderly man
History-and Physical Examination-Based Model Showed Good Discrimination Ability in Fracture Prediction
The Abstract Book can be viewed at: http://2014.wco-iof-esceo.org/sites/ecceo14/docs/wco14-abstractbook.pdfPoster Presentatio
Advanced Osteoporosis Triage System Shortens the Waiting Time for Osteoporosis Clinic
Young Hospital Authority Investigators PresentationsService Priorities and Programmes Free PaperIntroduction
Osteoporosis has become a major health problem both locally and worldwide. The waiting time for specialist clinics has
inevitably risen because of our aging population. An effective healthcare referral system is required to meet the growing
demand of service. To maintain a good standard of patient care, an Advanced Osteoporosis Triage System (AOTS) has been
commenced since 2012.
Objectives
(1) To evaluate the effectiveness of the AOTS; and (2) to monitor the waiting list in osteoporosis specialist clinic.
Methodology
Patients with osteoporosis referred to osteoporosis specialist clinic between January 2012 and January 2014 were assessed
by the AOTS. An experienced nurse in the field of osteoporosis, functioning as the case manager, would work with reference
to a clinical management protocol under the supervision of an endocrinologist. Patients were triaged to high-risk and nonhigh-
risk group based on various criteria including their latest clinical informations like presence of fracture, recent fall and
drug history; the Fracture Risk Assessment Tool (FRAX) score; investigations results such as bone mineral density, blood
tests for vitamin D, thyroid and parathyroid hormone levels etc. Clinical information was verified from the hospital’s Computer
Medical System (CMS) and updated by a structured telephone interview. The waiting time for a medical consultation in
the clinic among high-risk group and non-high-risk group were compared to a historical control group, which included the
patients being seen in the clinic before implementation of the AOTS.
Results
1,689 patients with 32 male (2%) and 1,654 female (98%), were referred during the period studied. The mean age of the
patient was 75±11 years. 331 patients (20%) were triaged to high-risk group. Patients being triaged to the high-risk group
included those with secondary causes of osteoporosis identified, such as vitamin D deficiency (number=131, 40%), thyroid
disease (number=26, 8%), primary hyperparathyroidism (number=7, 2%); those with high fracture risk as reflected by FRAX
score (number=7, 2%); those with recent history of fracture (number=28, 9%) or recurrent fall (number=5, 1%); and those with
comorbid medical conditions, such as impaired renal function (number=61, 18%), diabetes (number=14, 4%) or intolerance to
anti-osteoporosis drugs (number=46, 14%).
Education, further investigations, and appropriate referral were arranged by the case manager before medical consultation
in osteoporosis clinic. After the implementation of AOTS, the waiting time for osteoporosis specialist clinic in high-risk group
were significantly shortened (15±3 versus 28±2 weeks) (p<0.05) compared with the control group. The waiting time of the
non-high-risk group has been maintained and showed no significant difference from the control (28±1 weeks versus 28±2
weeks) (p=0.17). The AOTS demonstrates an effective model which enhances the provision of specialist service to the most
appropriate patients in a more timely way. Not only can shorten the clinic waiting time but also help in early identification of
underlying diseases