{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:44Z","timestamp":1787755604046,"version":"build-2784847793"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Osteoporosis continues to be underdiagnosed and inadequately treated in older hip-fracture patients. Our aim was to improve the rate of osteoporosis treatment with IV bisphosphonate therapy in eligible patients admitted for hip-fracture surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The present study was designed as a quality improvement initiative using Plan-Do-Study-Act (PDSA) cycles at an academic medical center in Portland, Oregon, over 2.5 years. A protocol was developed (1) to administer IV zoledronate on postoperative day 2 to inpatients aged \u226550 years who underwent surgery for a low-energy hip fracture and (2) to formally diagnose osteoporosis during admission. The protocol was introduced across 3 care settings in a stepped-wedge manner. Outcome measures were the percentage of inpatient zoledronate administered to eligible patients and formal documented diagnosis of osteoporosis. Balance measures included fever after administration and hospital length of stay (LOS). Measures were assessed through quarterly chart review and tracked via control charts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The rate of zoledronate administration significantly increased from 34.5% (29 of 84) to 74.6% (53 of 71) following the second PDSA cycle (p &lt; 0.001). Documented osteoporosis diagnosis also significantly improved from 51.0% (53 of 104) to 85.7% (96 of 112) following the second PDSA cycle (p &lt; 0.001). No significant differences were shown for hospital LOS, and 1 of 82 patients had medical work-up for post-infusion acute phase reaction after administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This initiative was effective at improving osteoporosis diagnosis and treatment among older hip-fracture patients at our institution. Protocol development for administrating inpatient zoledronate after hip fracture is a reliable way to predictably offer bone health care and secondary-fracture prevention to hip-fracture patients and can be adapted and implemented at other institutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Diagnostic\n                      <jats:underline>Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.24.00766","type":"journal-article","created":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T14:00:34Z","timestamp":1739541634000},"page":"709-716","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["A Hip New Standard"],"prefix":"10.2106","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-3822","authenticated-orcid":false,"given":"Naomi M.","family":"Turner","sequence":"first","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0093-7429","authenticated-orcid":false,"given":"Marissa Song","family":"Mayeda","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4603-4084","authenticated-orcid":false,"given":"Bryanna","family":"De Lima","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0534-879X","authenticated-orcid":false,"given":"Darin","family":"Friess","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3476-5832","authenticated-orcid":false,"given":"Yee-Cheen","family":"Doung","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0086-5197","authenticated-orcid":false,"given":"Kathleen","family":"Drago","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,14]]},"reference":[{"issue":"10","key":"bib1-20250714","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1007\/s00198-014-2794-2","article-title":"Clinician\u2019s Guide to Prevention and Treatment of Osteoporosis","volume":"25","author":"Cosman","year":"2014","journal-title":"Osteoporos Int."},{"issue":"9","key":"bib2-20250714","doi-asserted-by":"crossref","first-page":"2243","DOI":"10.1007\/s00198-015-3154-6","article-title":"Burden of high fracture probability worldwide: secular increases 2010-2040","volume":"26","author":"Od\u00e9n","year":"2015","journal-title":"Osteoporos Int."},{"issue":"7","key":"bib3-20250714","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.2106\/JBJS.L.01781","article-title":"Declining rates of osteoporosis management following fragility fractures in the U.S., 2000 through 2009","volume":"96","author":"Balasubramanian","year":"2014","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib4-20250714","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1186\/s12891-021-04051-9","article-title":"Fragility fracture identifies patients at imminent risk for subsequent fracture: real-world retrospective database study in Ontario, Canada","volume":"22","author":"Adachi","year":"2021","journal-title":"BMC Musculoskelet Disord."},{"issue":"4","key":"bib5-20250714","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1210\/er.2001-2002","article-title":"Meta-analyses of therapies for postmenopausal osteoporosis. 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