PDF(Pubmed)
Abstract：
This pilot audit explored how bone health is assessed patients with diabetes in diverse centres across Asia. Only 343 of 1092 (31%) audited patients had a bone health assessment, 27% of whom were diagnosed with osteoporosis. Quality improvement strategies are needed to address gaps in patient care in this area.
OBJECTIVE: The Asia Pacific Consortium on Osteoporosis (APCO) Framework outlines clinical standards for assessing and managing osteoporosis. A pilot audit evaluated adherence to clinical standard 4, which states that bone health should be assessed in patients with conditions associated with bone loss and/or increased fracture risk; this report summarises the audit findings in patients with diabetes. A secondary aim was to assess the practicality and real-world use of the APCO bone health audit tool kit.
METHODS: Eight centres across Asia participated in the pilot audit, selecting diabetes as the target group. Participants reviewed their practice records for at least 20 consecutively treated patients with the target condition. Questions covered routine investigations, bone health assessment, osteoporosis diagnosis, and patient referral pathways. Data were summarised descriptively.
RESULTS: The participants represented public hospitals, university medical centres, and private clinics from India, Malaysia, Pakistan, Singapore, Taiwan, and Vietnam that see an estimated total of 95,000 patients with diabetes per year. Overall, only 343 of 1092 audited patients (31%) had a bone health assessment. Osteoporosis was subsequently diagnosed in 92 of 343 (27%) patients.
CONCLUSIONS: Bone health was not assessed in most patients with diabetes. The results provide insight into current practices across diverse Asian centres and demonstrate the practical value of the audit tool kit. Participant feedback has been used to improve the tool kit. Results of this pilot audit are being used in the respective centres to inform quality improvement projects needed to overcome the gap in patient care.
OBJECTIVE: The Asia Pacific Consortium on Osteoporosis (APCO) Framework outlines clinical standards for assessing and managing osteoporosis. A pilot audit evaluated adherence to clinical standard 4, which states that bone health should be assessed in patients with conditions associated with bone loss and/or increased fracture risk; this report summarises the audit findings in patients with diabetes. A secondary aim was to assess the practicality and real-world use of the APCO bone health audit tool kit.
METHODS: Eight centres across Asia participated in the pilot audit, selecting diabetes as the target group. Participants reviewed their practice records for at least 20 consecutively treated patients with the target condition. Questions covered routine investigations, bone health assessment, osteoporosis diagnosis, and patient referral pathways. Data were summarised descriptively.
RESULTS: The participants represented public hospitals, university medical centres, and private clinics from India, Malaysia, Pakistan, Singapore, Taiwan, and Vietnam that see an estimated total of 95,000 patients with diabetes per year. Overall, only 343 of 1092 audited patients (31%) had a bone health assessment. Osteoporosis was subsequently diagnosed in 92 of 343 (27%) patients.
CONCLUSIONS: Bone health was not assessed in most patients with diabetes. The results provide insight into current practices across diverse Asian centres and demonstrate the practical value of the audit tool kit. Participant feedback has been used to improve the tool kit. Results of this pilot audit are being used in the respective centres to inform quality improvement projects needed to overcome the gap in patient care.
摘要：
这项试点审计探讨了如何评估亚洲不同中心的糖尿病患者的骨骼健康。1092名接受审计的患者中只有343名（31%）接受了骨骼健康评估，其中27％被诊断为骨质疏松症。需要质量改进策略来解决该领域患者护理方面的差距。
目的：亚太骨质疏松协会（APCO）框架概述了评估和管理骨质疏松的临床标准。一项试点审核评估了对临床标准4的依从性，该标准指出，应评估与骨丢失和/或骨折风险增加相关的患者的骨健康；本报告总结了糖尿病患者的审核结果。次要目的是评估APCO骨骼健康审核工具包的实用性和实际使用情况。
方法：亚洲八个中心参与了试点审核，选择糖尿病为目标人群。参与者回顾了至少20名连续治疗的目标条件的患者的实践记录。问题涵盖例行调查，骨骼健康评估，骨质疏松诊断,和患者转诊途径。数据进行了描述性总结。
结果：参与者代表公立医院，大学医学中心,印度的私人诊所，马来西亚,巴基斯坦,新加坡,台湾,越南每年估计有95,000名糖尿病患者。总的来说,在1092例接受审核的患者中,只有343例(31%)进行了骨健康评估.随后在343例患者中有92例（27％）被诊断出骨质疏松。
结论：在大多数糖尿病患者中没有评估骨健康。结果提供了对不同亚洲中心的当前做法的见解，并证明了审计工具包的实用价值。参与者的反馈已用于改进工具包。该试点审核的结果已在各自的中心中使用，以告知克服患者护理差距所需的质量改进项目。
目的：亚太骨质疏松协会（APCO）框架概述了评估和管理骨质疏松的临床标准。一项试点审核评估了对临床标准4的依从性，该标准指出，应评估与骨丢失和/或骨折风险增加相关的患者的骨健康；本报告总结了糖尿病患者的审核结果。次要目的是评估APCO骨骼健康审核工具包的实用性和实际使用情况。
方法：亚洲八个中心参与了试点审核，选择糖尿病为目标人群。参与者回顾了至少20名连续治疗的目标条件的患者的实践记录。问题涵盖例行调查，骨骼健康评估，骨质疏松诊断,和患者转诊途径。数据进行了描述性总结。
结果：参与者代表公立医院，大学医学中心,印度的私人诊所，马来西亚,巴基斯坦,新加坡,台湾,越南每年估计有95,000名糖尿病患者。总的来说,在1092例接受审核的患者中,只有343例(31%)进行了骨健康评估.随后在343例患者中有92例（27％）被诊断出骨质疏松。
结论：在大多数糖尿病患者中没有评估骨健康。结果提供了对不同亚洲中心的当前做法的见解，并证明了审计工具包的实用价值。参与者的反馈已用于改进工具包。该试点审核的结果已在各自的中心中使用，以告知克服患者护理差距所需的质量改进项目。
