Bone Abstracts

Background: In 2022, OLHCS established a Clinical Nurse Specialist (CNS) led Bone Health (BH) clinic, aligned with Slintecare (2018) and the HSE Model of Care for Rheumatology (2017), in response to the recognized risk of bone loss in individuals with rheumatic diseases. In June 2024, a quality improvement initiative was introduced to evaluate the addition of physiotherapy input into the existing clinic.

Aim: The goal was to enhance multidisciplinary working, evaluate outcomes using patient-reported outcome measures (PROMs), and perform a service evaluation. This abstract will outline the processes involved and include the preliminary data collected from June 2024 to June 2025.

Method: The BH CNS clinic reviews three individuals per month. The focus is on education/self-management, nutrition, medication, Fracture Risk Assessment (FRAX), and DEXA. The senior physiotherapist contributes interventions on exercise, falls prevention, and referrals. The pathway offers five episodes of care over 612 months, after which individuals are either discharged or continue in regular rheumatology clinics. The Osteoporosis Knowledge Test (OKT; 2011, 2012), a validated outcome measure, was implemented in October 2024, following author approval. It was administered at the initial visit and post-discharge to measure improvement in patient knowledge. A satisfaction questionnaire was also used to gather feedback.

Results: From June 2024 to June 2025, 25 individuals attended the clinic, excluding non-attendees. 19 completed the care pathway and were discharged from the service. There is complete pre and post-data for seven individuals. Those receiving ongoing treatment have not completed the OKT. Results showed 71% of respondents improved their BH knowledge. Ten individuals completed the satisfaction survey, with 100% reporting satisfaction and improved knowledge.

Conclusion: Integrating physiotherapy into the CNS-led Bone Health clinic improved patient knowledge and was highly valued by attendees, suggesting that targeted multi-disciplinary input can strengthen fracture-prevention education and self-management, in rheumatology out-patients. Compatible with Slintecare, this approach offers a practical pathway for regional roll-out of multidisciplinary bone health services in future.