SFEBES2026 Oral Poster Presentations Bone and Calcium (4 abstracts)
An endocrine nurse led cinacalcet clinic? saving money, avoiding admissions and keeping patient safe!
Heather Sullivan 1 , Mohammed Shamsaldeen 2 , Sumudu Bujawansa 1 , Sam Westall 1 , Eithuzar Aung 3 , Tala Balafshan 1 , Sid McNulty 1 , Niall Furlong 1 , Andrew Lewis 1 , Dhanya Kalathil 1 & Ram Prakash Narayanan 1
1Mersey and West Lancashire Teaching Hospitals NHS Trust, St. Helens, United Kingdom; 2Warrington and Halton Teaching Hospitals Nhs Foundation Trust, Warrington, United Kingdom; 3Mersey and West Lancashire Teaching Hospitals NHS Trust, Mersey and West Lancashire Teaching Hospitals NHS Trust, United Kingdom
Background: Primary hyperparathyroidism is a progressive condition causing multiple symptoms and complications including: hypercalcaemia, polyuria, bone pain, constipation, confusion, osteoporosis and kidney stones. Incidence rises with age and many patients with significant hypercalcaemia are not appropriate surgical candidates or may be awaiting surgery and require Cinacalcet a medication to manage hypercalcaemia. In Merseyside, Cinacalcet prescription is secondary care retained, requiring biochemical monitoring a week after commencement or dose adjustment and 3-monthly thereafter. Secondary care prescriptions rely on patient-initiated requests. In a cohort of elderly patients at risk of confusion, this can lead to reduced concordance and subsequent hypercalcaemia.
Aim: This project aimed to assess the safety of our current management with Cinacalcet therapy.
Method: Pharmacy identified all patients prescribed Cinacalcet between 1/4/22 and 27/9/23. Using electronic records, each case was reviewed, identifying hypercalcaemia associated hospital admissions and frequency of outpatient contact. The total cost of these hospital stays was calculated to assess the financial impact using the NHS National Tariff for inpatient care 2022-2023.
Results: 21 patients identified on Cinacalcet, of which 13 conservatively managed and 8 awaiting surgery. 6 patients experienced 11 admissions due to hypercalcaemia, with an average admission of 9.4 days (range 3-23), totalling 85 bed-days. Causes for hypercalcaemia, requiring hospitalisation included: running out of medications, infrequent monitoring, illness and unknown. This resulted in an estimated combined cost of £66,814 (up to £6,074 per admission for electrolyte disorders, with interventions).
Conclusion: We concluded current practice was not adequate to effectively manage patients on Cinacalcet. We proposed a dedicated band 7 endocrine nurse led monthly Cinacalcet clinic, with a database for prescriptions, biochemistry monitoring and review of calcium related admissions if they occur. 12 sessions would cost an estimated £1,141/year, saving approximately £65,673/year. This clinic will start in January 2026, saving money, avoiding admissions, and keeping patients safe.
Volume 117
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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