Correct administration – with pre-dose safety checks recorded
Bone health monitoring – calcium, vitamin D, renal, and dental assessments
Patient counselling – about fracture risk, dental issues, and supplementation
Accurate coding – supporting reimbursement and audit
Pre-procedure checks – risks, consent, safety checks
Administration details – indication, route/site, needle size
Post-procedure documentation – outcome, advice, sharps disposal, Yellow Card if required
It also includes denosumab-specific sections:
Indication (osteoporosis, oncology, giant cell tumour, or other)
Pre-dose checks (calcium, vitamin D, renal function, dental health)
Patient counselling (supplements, monitoring, dental risks, femoral fracture symptoms)
Leaflet provision
Where a Local Enhanced Service exists, a section will appear automatically at the top of the template.
This ensures denosumab injections are coded and claimable correctly.
You do not need to find or use a separate LES template.
Risks discussed (pain, bleeding, infection, allergic reaction, fainting)
Consent obtained and recorded
Injection under PGD or PSD
6 safety checks completed
Vaccine cold chain confirmed (if relevant)
Indication recorded (osteoporosis, oncology, giant cell tumour, or other)
Tick box to confirm denosumab given
Site: SC upper arm, thigh, abdomen, or other
Record needle size
Confirm injection given and tolerated
Outcome: no reaction, faintness, pain/swelling, allergic reaction
Sharps disposed of safely
Aftercare advice given
Yellow Card submitted if adverse reaction suspected
Always complete pre-dose checks before giving denosumab (calcium, vitamin D, renal, dental health).
Reinforce patient counselling:
Maintain calcium + vitamin D supplementation
Report jaw symptoms (osteonecrosis risk)
Report thigh/groin pain (possible atypical femoral fracture)
Provide the patient leaflet at initiation and review visits.
Use the LES section at the top of the template for coding/claiming.