The Lydia Osteoporosis Project

Queen Margaret University in Edinburgh has received a significant donation of over half a million pounds from anonymous benefactors to progress research and education into osteoporosis. The Lydia Osteoporosis Project is led by a team of Queen Margaret University nurse researchers and education specialists based in the Division of Nursing, Occupational Therapy and Arts Therapies in the School of Health Sciences. The overall aim of the Lydia Osteoporosis research and education project is to:

“reduce the risk to patients with osteoporosis of accidental injury potentially linked to moving and handling by health care staff, by improving staff’s knowledge and skills and by ensuring that the patients’ condition is known to staff by virtue of a ‘risk identifier’.

A mixed methods research design is being used to investigate the moving and handling needs of older patients [aged 65+] with osteoporosis in acute hospitals and to explore possible links between the moving and handling of patients with osteoporosis and accidental injury. A critical review of the patient handling literature informs the research. The research phase comprises:

• Quantitative analysis of ISD data and, if available, anonymised data to determine the incidence of fractures in the study population.
• Qualitative interviews with registered healthcare professionals to gain their views and experiences of moving and handling patients with osteoporosis
• Qualitative interviews with patients with osteoporosis to gain their views and experiences of moving and handling.

Depending on the findings from the research phase the education phase may comprise the following:

• Development of an education package aimed at all staff involved in the moving and handling of patients with osteoporosis in the acute hospital environment.
• Development of an ‘at risk identifier’ to alert staff to the moving and handling needs of the patient with osteoporosis in hospital
• Following discussion with NHS partners dissemination and roll out to NHS and other stakeholders of an ‘at risk identifier’ and an education package.

Facts and figures about Osteoporosis

Osteoporosis affects 200 million women worldwide including

• 1/3 of females aged 60 to 70 years
• 2/3 of females aged 80 years and over (IOF, 2005)

30% of females over 50 years of age sustain one or more vertebral fractures (Dennison & Cooper, 2000)

1 in 5 males over 50 years of age will sustain a fracture linked to osteoporosis (IOF, 2005).

Definition of terms:

 'Osteoporosis' is defined according to the European Guidance on Diagnosis and Management of Osteoporosis by measuring Bone Mineral Density (BMD) by using predominantly DEXA scans (Kanis et al 2008). Patients can be classed as having normal BMD, low BMD (osteopenia), osteoporosis and severe osteoporosis (Kanis et al 2008).

‘Accidental injury’ here refers to any low trauma fracture or musculoskeletal injury occurring in osteoporosis patients following admission to an acute hospital. ‘Low trauma fractures' are defined as, “fractures that result from low-level trauma, which means mechanical forces that would not ordinarily cause fracture. The World Health Organisation has quantified these as forces equivalent to a fall from a standing height or less” (NICE 2004).

‘Moving and handling' refers to the risk assessment carried out by healthcare staff to prevent musculoskeletal injuries and to the interventions undertaken to assist patients to move or change position including repositioning in bed, transfers from bed to chair or trolley, help to stand and walk, and to healthcare staff's choice and use of moving and handling aids (Hignett et al 2003, Smith 2005).

Progress on the Lydia Osteoporosis Project:

 Achievements

• The project team established links with clinical networks and specialist clinicians during the Spring of 2011 (including the Chair of the National Osteoporosis Society, the Development Manager for the National Osteoporosis Society, Falls Coordinators, Moving and Handling Advisers, the Osteoporosis Service, and NHS Managers).
• The Steering Group was established in February 2011 and the first two steering group meetings were held in March and September 2011.
• The Lydia Osteoporosis Project Logo was finalised in Spring 2011.
• An extensive search of the literature and critical appraisal of research evidence was undertaken during 2011.
• A QMU web page was developed in April 2011 and a ‘donating’ link was added in September 2011
• The final version of the research proposal was submitted to NHS Ethics in November 2011.
• The research proposal gained NHS Ethics, R&D and Caldicott Guardian Approvals (December 2011 to February 2012).
• The Principal Investigator attended the 25 th Anniversary celebration of the NOS in Scotland at the Scottish Parliament, Holyrood on 8 th November 2011.

Objectives up to June 2012

• To complete data collection and preliminary data analysis by June 2012.
• Meet with Moving and Handling Advisers, Falls Coordinators and members of Osteoporosis Services across Scotland in preparation for the education phase of the project.

 Membership of the Lydia Osteoporosis Project team at Queen Margaret University:

The project team at Queen Margaret University includes the following members of staff:

• Dr Margaret C Smith, Principal Investigator, Lydia Osteoporosis Project*
• Dr Shona Cameron, Project Manager, Senior Lecturer
• Dr Lindesay Irvine, Senior Lecturer
• Mr Robert Rush, Statistician, School of Health Sciences
• Ms Fiona O’May, Research Fellow
• Dr Savina Tropea, Research Assistant

*For further information about the project please contact Dr Margaret C Smith

Membership of the Steering Group for the Lydia Osteoporosis Project:

 The Steering Group for the Lydia Osteoporosis Project includes the internal project team members and the external members listed below:

• Professor David Reid, Chair of the National Osteoporosis Society, Consultant Rheumatologist, University of Aberdeen, NHS Grampian.
• Professor Stuart Ralston, Professor of Medicine, University of Edinburgh.
• Dr Donald Farquhar, Consultant Physician and Geriatrician, NHS Lothian.
• Mrs Anne Simpson, Development Manager for Scotland, National Osteoporosis Society.
• Professor Pam Smith, Acting Head of Nursing, University of Edinburgh.
• Professor Nigel Gleeson, Rehabilitation Sciences, Queen Margaret University.
• Mrs Jackie Berg, Osteoporosis Nurse Specialist, NHS Lothian.
• Mrs Gina De Lara, Osteoporosis Nurse Specialist, NHS Lothian.

Links to useful websites:

National Osteoporosis Society

International Osteoporosis Foundation