{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:03:40Z","timestamp":1753877020337,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"In 2020 AMGEN"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The Metabolic Bone Health Department, Cardiff and Vale University Health Board, serves a local population of approximately 445\u2009000 people. A retrospective audit of attendance data regarding the denosumab treatment clinic (the traditional treatment pathway) and the denosumab Self-Injection Program (SIP) was conducted to determine whether the SIP is both cost-effective and environmentally beneficial, compared to the traditional treatment pathway. Cost analysis was then conducted by the Finance Department. The audit was conducted over 3\u00a0years following the implementation of the service development; 233 patients had enrolled in the program at the time of the audit and 69 had completed 3\u00a0years of self-injected treatment. A control group of 497 patients were identified by the service. This group remained on the historical pathway and had consistent attendance activity over the 3-yr period from 2017 to 2019. Pre- and post-period activity of all patients on the program was compared, together with the activity for the independent control group. The SIP resulted in a reduction in clinical contacts, with financial analysis showing a total opportunity cost saving per patient of \u00a3420 per annum. There were obvious benefits to the patient of a reduced number of visits to a clinical site, which also resulted in an estimated carbon footprint reduction of 59 kg CO2 per patient per annum. The cost analysis is based on our organization\u2019s 2022 charges. The SIP demonstrates that by focusing on care \u201ccloser to home\u201d, it is possible to maximize resources, improve the patient experience through reduced travel, and reduce the environmental impact of healthcare.<\/jats:p>","DOI":"10.1093\/jbmrpl\/ziae092","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T16:49:10Z","timestamp":1721234950000},"source":"Crossref","is-referenced-by-count":0,"title":["A retrospective audit with subsequent cost and environmental analysis of a denosumab self-injection program"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6104-2925","authenticated-orcid":false,"given":"Jack","family":"Boylan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Turton","sequence":"additional","affiliation":[{"name":"The Bone Research Unit, Llandough University Hospital, Llandough, Cardiff and Vale University Health Board , Wales , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Hicks","sequence":"additional","affiliation":[{"name":"The Finance Department , Cardiff and Vale University Health Board, Wales , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia","family":"Cottam","sequence":"additional","affiliation":[{"name":"The Finance Department, Cardiff and Vale University Health Board , Wales , United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Stone","sequence":"additional","affiliation":[{"name":"The Bone Research Unit, Llandough University Hospital, Llandough, Cardiff and Vale University Health Board , Wales , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"volume-title":"Moving Healthcare Closer to Home: Financial Impacts","year":"2015","author":"Monitor","key":"2024081214105251000_ref1"},{"issue":"1","key":"2024081214105251000_ref2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ageing\/afab220","article-title":"Is comprehensive geriatric assessment hospital at home a cost-effective alternative to hospital admission for older people?","volume":"51","author":"Singh","year":"2022","journal-title":"Age Ageing"},{"year":"2019","key":"2024081214105251000_ref3"},{"volume-title":"Cardiff and Vale University Health Board: Shaping Our Future Wellbeing Strategy 2015-2025","year":"2015","author":"Battle","key":"2024081214105251000_ref4"},{"volume-title":"Simply Prudent Healthcare \u2013 Achieving Better Care and Value for Money in Wales \u2013 Discussion Paper","year":"2013","author":"Aylward","key":"2024081214105251000_ref5"},{"volume-title":"A Healthier Wales: Our Plan for Health and Social Care","year":"2021","author":"Llywodraeth Cymru\/Welsh 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Metab"},{"issue":"2","key":"2024081214105251000_ref10","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/jbmr.3337","article-title":"Vertebral fractures after discontinuation of denosumab: a post hoc analysis of the randomized placebo-controlled FREEDOM trial and its extension","volume":"33","author":"Cummings","year":"2017","journal-title":"J Bone Miner Res"},{"volume-title":"Clinical Guideline for the Prevention and Treatment of Osteoporosis","year":"2021","author":"National Osteoporosis Guideline Group","key":"2024081214105251000_ref11"}],"container-title":["JBMR 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