P078 Bone health in men with prostate cancer on androgen deprivation therapy: audit and service development

Abstract

Background/Aims Androgen deprivation therapy (ADT) is commonly used in the treatment of prostate cancer. A significant complication of ADT use is osteoporosis. National and international guidelines recommend a fracture risk assessment (FRA) based on clinical factors and bone mineral density (BMD) to guide bone agent (BA) use and bone protection advice. We audit our current performance, and subsequently offer a novel interdisciplinary service to optimise patients’ bone health. Methods Retrospective hospital analysis of patients with metastatic prostate cancer or pre-radiotherapy seen in 2 hospitals over a 6-month period. Patients intended for >6 months treatment were assessed against guideline standards and a retrospective FRA was performed. Results 82 patients were captured. Age range 62 to 92, median age 77.3. 4.9% patients were already known to the osteoporosis service, but none had been referred for a bone health assessment with the commencement of ADT. Table 1 illustrates our performance against guidelines and the likely need for a BA in a post-hoc analysis at one site. As a result of the collaborative audit undertaken between the urology and osteoporosis services that demonstrated poor recognition of bone health in patients on ADT, the teams worked collaboratively to design a guideline for assessing and managing these patients. This included reviewing the information given to patients about the risk of ADT to bone health, resources that the urology team can signpost patients to, and the initiation of appropriate BA to be undertaken by an appropriately trained person/team. Conclusion ADT use can accelerate bone loss, therefore users need FRA and BMD assessments to appropriately guide management. Self-management to optimise bone health by patients can be improved by providing appropriate bone protection advice (regular exercise and adequate vitamin D and calcium intake). Bone health assessments in patients on ADT is a major unmet need that requires attention to minimise clinical risk to patients. The new assessment tool and management pathway in our Trust estimates 114 new patients annually requiring FRA with a maximum number of 372 DXA scans per year accounting for those requiring 2-yearly scans to monitor BMD until the age of 80. Disclosure Z. Sheng: None. P. Srivastava: None. J. Shah: None. S. Yaqub: None. R. Laxminarayan: None. A. Ugur: None. S. Williams: None. S. Broadhurst: None. J. Tipper: None. C. Haynes: None. M. Hui: None.