On Monday at the 2017 annual meeting of the American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP), a team of researchers proposed using a bone health team to remotely screen, monitor, and treat veterans at risk for fragility fractures. Led by Karla L. Miller of Veterans Affairs Salt Lake City Health Care System and University of Utah School of Medicine in Salt Lake City, the authors found that the model is a potentially more cost-effective compared to current clinical practice at the Veterans Administration (VA).
The team used an adaptation of a previously validated Markov microsimulation model of osteoporosis incidence and outcomes at the VA to estimate fracture events, quality-adjusted life years (QALYs), and direct healthcare costs using a bone health team versus current clinical practice. They found that a bone health team would have diagnosed a substantially higher proportion of patients with underlying osteoporosis or osteopenia and subsequently treated them with bisphosphonates, leading to a modestly lower fracture rate than current clinical practice.
They recommended further study of a bone health team to examine its cost-effectiveness versus no intervention. They said the feasible, team-based approach to this important problem has the potential to unburden the increasingly limited time and availability of primary care providers.