022 Meds Management: Bisphosphonate
The Bisphosphonate prescribing searches are designed to identify patients who are currently prescribed a bisphosphonate medication on repeat, and have had an issue in the last 3 months.
The Bisphosphonate folder forms part of 022 Meds Management
Result of concern
The search On bisphosphonate and latest eGFR or Creatinine of concern will find any patient whose most recent eGFR is less than 35 or their latest creatinine clearance is less than 40. The corresponding report will show the drug, latest eGFR, and latest Creatinine clearance to assist in targeting information and dates before loading the record.
The safety recommendation is to stop the bisphosphonate if the eGFR or creatinine clearance is below a certain level indicating severe renal impairment.
This search is dependent on timely and accurate coding of information. eGFRs come into the clinical system electronically, but creatinine clearance is dependent on one being calculated and coded. If a patient is being pulled into the search by an old or outdated value, retest if appropriate and recalculate the creatinine clearance.
No recent monitoring
Bisphosphonates should be monitored at least annually to check renal function. Patients who do not have an eGFR or creatinine clearance coded in the last 12 months will be picked up by this search. The action is to check the record for uncoded results before arranging for bloods monitoring.
This folder should only be run using today's date to gather the most up-to-date information.