Introduction Parkinson’s disease (PD) patients with or without psychosis are at higher risk of recurrent falls and fracture and, as a consequence, higher mortality and morbidity NICE (13) Henderson et al. (2019). We conducted a qualitative study to understand barriers and facilitators of introducing ‘bone health assessment’ for PD patients. Method We conducted a pilot study to identify and implement a bone health assessment tool to communicate falls and fracture risks to GPs. • SWOT and Stakeholder analysis was conducted to identify an appropriate bone health assessment tool. • PDSA cycles were completed to assess barriers and facilitators of bone health assessment in all PD clinical areas. • 4 Participants were identified from all possible PD clinical settings and trained on how to use the FRAX assessment tool. • Semi structured interviews were conducted to explore themes from 6-week pilot study. Results Bone health assessments were not conducted routinely in PD clinical settings in our Trust Literature review/SWOT and Stake holder analysis identified ‘FRAX’ score as an appropriate bone health assessment tool for PD patients. Interviews with participants identified time constraints during the clinical consultation as a major barrier to conducting bone health assessment using the FRAX assessment tool. All participants agreed that this improved communication with patients and GPs in understanding bone health and risk of falls and fractures. Face to face PD Nurse Clinics were deemed the most appropriate clinical settings for these assessments. Conclusion As a result of this service improvement project bone health is now assessed in all PD Nurse clinics. This has enabled GPs to start the most appropriate bone protection treatment for PD patients.

中文翻译：

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2341 在大学医院环境中为帕金森病患者引入骨骼健康评估的定性评估


简介 患有或不患有精神病的帕金森病 （PD） 患者复发性跌倒和骨折的风险更高，因此死亡率和发病率更高 NICE （13） Henderson 等人 （2019）。我们进行了一项定性研究，以了解为 PD 患者引入“骨骼健康评估”的障碍和促进因素。方法 我们进行了一项试点研究，以确定并实施骨骼健康评估工具，以将跌倒和骨折风险传达给全科医生。• 进行 SWOT 和利益相关者分析以确定合适的骨骼健康评估工具。• 完成 PDSA 周期以评估所有 PD 临床领域骨骼健康评估的障碍和促进因素。• 从所有可能的 PD 临床环境中确定了 4 名参与者，并接受了如何使用 FRAX 评估工具的培训。• 进行了半结构化访谈以探索为期 6 周的试点研究的主题。结果 在我们的信任文献综述/SWOT 中，骨骼健康评估未在 PD 临床环境中常规进行，利益相关者分析确定“FRAX”评分是适合 PD 患者的骨骼健康评估工具。与参与者的访谈发现，临床咨询期间的时间限制是使用 FRAX 评估工具进行骨骼健康评估的主要障碍。所有参与者都同意，这改善了与患者和全科医生在了解骨骼健康以及跌倒和骨折风险方面的沟通。面对面的 PD 护士诊所被认为是最适合这些评估的临床环境。结论 作为这项服务改进项目的结果，现在所有 PD 护士诊所都评估了骨骼健康。这使全科医生能够开始为 PD 患者进行最合适的骨骼保护治疗。