CPD PDSA guide
A worked PDSA cycle for recovering overdue denosumab (Prolia) recalls, building a reliable reminder system that keeps patients within the 6-month dosing window, and meeting CPD requirements as a whole practice team.
Denosumab (Prolia) has no residual activity once a dose is delayed or missed. Bone turnover rebounds rapidly and bone mineral density gains are quickly reversed, with vertebral fracture risk nearly quadrupling beyond a 16-week delay. For GP practices, keeping every patient within the 6-month dosing window is a procedural task that depends on a reliable recall system.
This guide takes your practice team through a complete Plan-Do-Study-Act (PDSA) cycle focused on Prolia recall recovery. It covers identifying overdue patients, the recall methods that work, the reminder-at-time-of-administration protocol that prevents recurrence, and the clinical knowledge base for denosumab including discontinuation, transition therapy and MRONJ timing. The worked example shows how a real practice recovered a backlog of 66 overdue patients across three monthly cycles.
Completing the full cycle can contribute up to 9 Continuing Professional Development (CPD) hours across Educational Activities, Reviewing Performance and Measuring Outcomes categories when submitted as a practice-based or group activity.
Identifying overdue Prolia patients via database search, working through the backlog, and the comparison of phone contact against automated recall for this patient group.
The reminder-at-time-of-administration protocol, the at-injection checklist, reminder cards and the monthly overdue search that keeps the backlog from growing.
Denosumab mechanism, indications, contraindications, monitoring, discontinuation and transition therapy, dental extraction timing and patient education.
Completing the full PDSA cycle can contribute up to 9 CPD hours. The breakdown below shows how hours are allocated across RACGP CPD categories.
Review of denosumab management, fracture risk evidence and the practice knowledge base.
Reviewing overdue Prolia recalls against the dosing schedule and setting recovery targets.
Tracking overdue recalls across three monthly cycles and confirming the trend holds.
Delayed dosing and rebound fracture risk
Overdue recall identification and recovery
Reminder systems and the at-injection checklist
Discontinuation and transition therapy
MRONJ and dental extraction timing
Reliable Prolia recall protects patients from rebound fractures and supports continuity of care.
Keeping every patient within the 6-month window prevents the rapid bone loss and rebound vertebral fractures that follow missed or delayed doses.
Consistent recall supports GP Chronic Condition Management Plan review where appropriate, nurse monitoring under MBS item 10997, and fewer missed appointments.
This PDSA guide is free for Australian GP practices.