Poster Presentation ESA-SRB-ANZBMS 2024 in conjunction with ENSA
The cost effectiveness of an osteoporosis clinical nurse consultant-driven zoledronic acid infusion service. (#378)
Background:
Introduction of an endocrine clinical nurse consultant at the Royal Melbourne Hospital has improved access to endocrine testing and treatment. Zoledronic acid (ZA) is a potent bisphosphonate, however its use is limited to oversubscribed osteoporosis clinics due to its intravenous route of administration. ZA treatment courses typically involve at least three doses annually in hospital day units. Following initial prescription, an Osteoporosis Clinical Nurse Consultant (OCNC) with ability to organise subsequent infusions through a zoledronic acid infusion service could improve access to hospital osteoporosis clinics and ZA use, while generating additional funding.
Aim:
Determine the feasibility and benefits of a 0.2FTE OCNC for prescribing and organising subsequent ZA infusions for severe osteoporosis.
Methods:
A 3-month retrospective audit of individuals attending weekly General Endocrinology/Bone and Mineral Clinic from August-October 2023 was conducted. We determined the proportion of appointments for bone disorders, those where ZA was prescribed, income generated from outpatient endocrinologist/OCNC clinic appointments and day admissions for ZA infusions, and employment costs of a 0.2FTE OCNC.
Results:
Over 3 months, 25 clinic appointments were solely for provision of subsequent ZA (Figure1). If these 25 Endocrinologist appointments were converted to OCNC appointments, newly available endocrinologist clinic appointments for consultations could generate NWAU funding of $6250 over 3-months (extrapolated to 100 new consultations /$25,000 income p.a.) (Table1). OCNC consultations would generate NWAU funding of $4227 over 3-months ($16,908 p.a.). 25 ZA infusions would continue to generate NWAU funding of $35,761.75 over 3-months ($143,047 per annum). Based on current referral and treatment practices, the OCNC-driven ZA infusion service is projected to grow by 32% p.a. ($45,775.04 p.a.). Employment costs of a 0.2FTE OCNC are approximately $20,000 p.a.
Conclusion:
An OCNC-driven ZA infusion service has the potential to significantly improve access to osteoporosis clinics and ZA provision, while increasing NWAU related hospital revenue.
