OP15 Improving The Osteoporosis Care Trajectory By Collaboration Between Clinicians, Patients And Health Insurers Within the Appropriate Care Program

Introduction The cyclic appropriate care program of the National Health Care Institute aims at enhancing quality in Netherlands. A full cycle consists four phases: (i) screening each ICD-10 chapter and selecting a trajectory, (ii) in-depth analysis trajectory formulating actions for improvement, (iii) implementation, (iv) evaluation. Collaboration with between relevant parties from field is key to its success. We describe 2nd 3th phase this cycle, aimed osteoporosis. Methods First, nine clinicians, one nurse practitioner, two physiotherapists pharmacist representing scientific organizations, patient representatives health insurer, defined research questions. Second, by on declaration data activities, comparing results guidelines, questions were addressed. Last, discussed among all making wiser choices improving appropriateness formulated. For action, who would take lead be involved. Results analyses showed that only 26 percent Dutch fracture patients 50 years age above underwent dexa-scanning, as opposed more than 80 guideline. All underlined percentage should increased. Possible defined: update multidisciplinary guideline; better inform about importance dexa-scanning; make adjustments hospital electronic system order facilitate ordering dexa-scans. these actions, medical specialists lead. Other data-analyses half osteoporosis stopped using medication within years. jointly raising adherence, such education, general practitioner Currently, facilitates implementation monitors improvement. Conclusions Close collaboration led well-considered improvement care.