Improving High-Risk Osteoporosis Medication Adherence and Safety With an Automated Dashboard.

Abstract

Background: Osteoporosis medications, notably anabolic therapies, necessitate careful oversight due to their high cost and laboratory monitoring requirements, precise dosing in clinics, and strategic sequencing. These challenges were exacerbated by the COVID-19 pandemic. To address this, we created an automated clinic dashboard to aid in population health management at a US Department of Veterans Affairs osteoporosis clinic.

Methods: An automated dashboard was created to host data for patients with ≥ 1 prescription for alendronate, zoledronic acid, abaloparatide, denosumab, or romosozumab when prescriptions, appointments, or laboratory tests were overdue or out of reference range.

Results: As of March 20, 2021, 139 patients were displayed on the dashboard; 29% were female aged 40 to 100 years. The dashboard alerted us to 92 (66%) veterans with unmet care needs. The most common alert was 40 overdue laboratory tests (29%); 37 were for patients receiving bisphosphonates (93%). Of the 23 patients (17%) that had overdue medications, 2 (8%) had not refilled oral bisphosphonates, and 18 (20%) were overdue for intravenous bisphosphonates appointments. Three patients transferred care to another clinic.

Conclusions: A dashboard alerted the osteoporosis team to veterans overdue for visits, laboratory tests, and prescription renewals, thus minimizing therapy gaps and supporting high-quality care and safety. Although the dashboard was developed in response to the COVID-19 pandemic, it remains a useful patient care resource. The dashboard serves as a valuable clinical support tool for osteoporosis care coordination and has the potential for use at other health care systems.