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Outcomes of an osteoporosis disease-management program managed by nurse practitioners


  • Disclosures Merck Pharmaceuticals Inc. contributed a minimal initial start up funding in the early stages of our program development (2002–2005) for research on using Fosamax as a part of our osteoporosis disease management program. We thank them for their brief involvement; we currently have no continued financial relationship with them.

Denise Greene, Kaiser Permanente, Orthopedics, 9897 Fonte Road, Cypress, CA 90242. Tel: 714-837-8898;
Fax: 562-657-4161;


Purpose: To detail the outcomes of an osteoporosis disease-management program where nurse practitioners (NPs) have taken a leadership role in screening, diagnosing, and treating patients at risk for osteoporosis.

Data sources: An electronic medical record (EMR) was used to collect demographic, pharmacy, dual x-ray absorptiometry (DXA) scan, and fracture data from a population of over 625,000 patients with one or more risk factors for osteoporosis. Monthly reports were generated and distributed to the NPs to assist them in identifying patients that required screening or treatment.

Conclusions: Over a 6-year period there was a 263% increase in the number of screening DXA scans done each year, a 153% increase in the number of patients on anti-osteoporosis medications each year, and a 38.1% decrease in the expected hip fracture rate.

Implications for practice: NPs play an important leadership role in managing osteoporosis within a large health maintenance organization. The screening and interventions used can be applied by any NP in any practice setting on an individual basis to reduce hip fracture rates in the United States.