P059 Comparing a novel audiovisual resource with written patient information leaflets to improve understanding and consent for intravenous zoledronic acid treatment in orthogeriatric patients

Background/Aims
Zoledronic acid is a first-line treatment for osteoporosis following hip fracture, reducing further fracture risk and associated morbidity and mortality. However, counselling practices can vary between clinicians, and older adults with visual impairment may have difficulty accessing written resources. This service evaluation assessed whether a novel audiovisual resource could improve patient understanding of the benefits and risks of zoledronic acid compared with standard written information.

Methods
This evaluation was conducted at a UK district general hospital between October 2024 - March 2025. Patients aged over 60 years admitted with low-impact femoral fractures who were recommended intravenous zoledronic acid were included. All patients received standard verbal counselling, the Royal Osteoporosis Society (ROS) factsheet, and a novel narrated audiovisual resource. Participants rated how much each resource helped their understanding of the benefits and risks of zoledronic acid using 5-point Likert scales (1 = ‘did not help at all’, 5 = ‘helped a lot’). Statistical analysis was performed using Wilcoxon signed-rank tests for paired comparisons and Mann-Whitney U tests for subgroup analysis, with rank-biserial correlation (r) for effect size.

Results
Thirty-six patients were analysed (mean age 80.9 years, 62% female). 25% (n = 9) had recorded visual impairment. Wilcoxon signed-rank testing showed significantly higher understanding scores for both treatment benefits (Z = -3.86, p < 0.05, r = 0.84) and risks (Z = -3.43, p < 0.05, r = 0.83) after viewing the audiovisual resource compared with the written factsheet. Subgroup analysis demonstrated a slightly greater effect size in visually impaired participants (r = 0.90) compared to those without visual impairment (r = 0.80-0.83). Mann-Whitney U tests comparing the two-subgroups revealed no statistically significant differences in patient-reported understanding (p > 0.05), indicating that the audiovisual resource was equally beneficial across both groups.

Conclusion
The audiovisual resource significantly enhanced patient understanding of zoledronic acid, particularly among visually impaired participants. Incorporating multimedia resources into standard counselling may improve accessibility, equity, and patient engagement in orthogeriatric care. Further evaluation should examine long-term knowledge retention, adherence, and wider clinical implementation.