The Lydia Osteoporosis Project
Queen Margaret University in Edinburgh received a significant donation of over half a million pounds from anonymous benefactors to progress research and education into osteoporosis. The Lydia Osteoporosis Project was launched in January 2011 by a project team comprising nurse researchers and education specialists based in the Division of Nursing in the School of Health Sciences.
The overall project aim :
To reduce the potential risk to people with osteoporosis of accidental injury linked to moving and handling, by increasing awareness of osteoporosis and increased fracture risk, and improving staff’s knowledge and skills through education.
The project objectives were as follows:
- To investigate the moving and handling needs of older people with osteoporosis in acute care by exploring the views and experiences of both registered healthcare professionals and people (aged 60 years and over) with a DEXA confirmed diagnosis of osteoporosis;
- To undertake a scoping review of the literature focusing on osteoporosis, moving and handling and the incidence of fractures in the study population;
- To collaborate with specialist clinicians and NHS managers, to undertake an education intervention feasibility study comprising the development, implementation and evaluation of an education workshop for healthcare staff to raise awareness of the prevalence of osteoporosis and the nursing care needs of people affected by osteoporosis.
- An initial project objective was to develop a risk identifier but this was superseded by the availability of robust fracture risk screening tools, particularly Q-Fracture.
- To disseminate the project findings to frontline staff and others using innovative web-based IT solutions.
- To complete a stakeholder evaluation of the Lydia Osteoporosis Project.
Facts and figures about Osteoporosis
- Osteoporosis affects:
- 50% of people aged 75+
- 3 million in UK
- 250,000 in Scotland (NOS 2015)
- 1:2 females > 50 years and 1:5 males > 50 years will suffer a fracture in the UK in their remaining lifetime (NOS 2013)
- Number of Low Trauma Fractures per annum (UK):
- Hip ♯ > 60,000, Wrist ♯ > 50,000, Vertebral ♯ > 120,000
- 1,150 hip fracture deaths/ month (UK)
- Only 25% vertebral fractures are linked to falls, most occur during everyday activities
- 90% hip fractures are falls related (NOS 2013)
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, Kanis et al 2013).
‘Low trauma fractures' are “fractures that result from low-level trauma, which means mechanical forces that would not ordinarily cause fracture. The WHO quantified these as forces equivalent to a fall from a standing height or less” (NICE 2004).
‘Moving and handling' refers to the risk assessments and the interventions undertaken by healthcare staff 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).
The Lydia Osteoporosis Project Design comprising Research, Education Implementation and Dissemination Phases:
- Phase 1: Exploratory qualitative research with healthcare professionals and people with confirmed osteoporosis diagnosis
- Phase 2: Education feasibility study to evaluate an experiential workshop & clinical simulation intervention to raise awareness of osteoporosis and the patient experience
- Phase 3: Development of a complex education intervention, ‘Caring for my bones’ focusing on osteoporosis, fracture risk and values-based safe and effective moving and handling for older people
- Phase 4: Dissemination of project findings. A fully responsive and bespoke interactive website and niche social network was commissioned by QMU with an external IT company in the summer of 2015. This introduces a social context for learning and aims to raise awareness of osteoporosis and the implications for moving and handling in acute care. This initiative promotes conversations between frontline staff, academics, students and the wider osteoporosis community and offers potential for expansion of education initiatives across health and social care.
Where we are now:
- Review of literature on osteoporosis, moving and handling and incidence of in hospital fractures.
- Exploratory qualitative research studies with healthcare professionals & people with osteoporosis.
- Education feasibility study with NHS staff.
- Complex education intervention development work focusing on moving and handling, ‘Caring for my bones’.
- Project dissemination phase and launch of Lydia Osteoporosis Project website/ niche social network, to ‘go live’ in November 2015.
- A stakeholder conference on 6 th November 2015.
- Preparation of publications for peer reviewed journals.
- Preparations for a second Lydia Osteoporosis Implementation and Evaluation Project to commence Autumn 2015.
Membership of the Lydia Osteoporosis Project team at Queen Margaret University comprised:
- Dr Margaret A C Smith, Principal Investigator* Lydia Osteoporosis Project, Senior Lecturer
- Dr Lindesay Irvine, Senior Lecturer (Education Phase 2)
- Mr Robert Rush, Statistician, School of Health Sciences (Phases 1 & 2)
- Ms Fiona O’May, Research Fellow (Phase 1)
- Ms Claire Pearson, Research Assistant (Phases 2 to 4, from December 2012)
- Mrs Rowena Wilson, Project Administrator (from 10 th July 2012 - June 2014)
- Dr Savina Tropea, Lecturer (Research Assistant Phase 1)
*For specific information about the project please contact Dr Margaret A C Smith
Membership of the Steering Group for the Lydia Osteoporosis Project:
The Steering Group for the Lydia Osteoporosis Project included the internal project team members (see above section) and the external members listed below:
- Professor David Reid, Head of School of Medicine and Dentistry, Consultant Rheumatologist, University of Aberdeen, NHS Grampian.
- Professor Stuart Ralston, ARC Chair of Rheumatology and Head of the School of Molecular and Clinical Medicine at the University of Edinburgh. Academic Director of Edinburgh Clinical Trials Unit and Honorary Consultant Rheumatologist with NHS Lothian.
- Dr Donald Farquhar, Consultant Physician and Geriatrician, NHS Lothian.
- Mrs Anne Simpson, Development Manager for Scotland, National Osteoporosis Society (retiring November 2015).
- Professor Pam Smith, Professorial Fellow, School of Health in Social Sciences, University of Edinburgh.
- Mrs Jackie Berg, Osteoporosis Nurse Specialist, NHS Lothian.
- Professor Nigel Gleeson, Rehabilitation Sciences, QMU.
- Dr Fiona Coutts, Dean of the School of Health Sciences, QMU.
- Professor Brendan McCormack Head of Division of Nursing from March 2014
International Osteoporosis Foundation
National Osteoporosis Society
Scottish Intercollegiate Guidelines (SIGN) Management of osteoporosis and the prevention of fragility fractures SIGN 142
Scottish Manual Handling Passport Scheme 2014
Preview the new Lydia Osteoporosis interactive website due to launch in November 2015