<<Miscellaneous:Practice Letterhead>>

TEAM CARE ARRANGEMENTS – Osteoporosis	
This Team Care Arrangement can be used for adult patients with established osteoporosis who may require multidisciplinary care e.g. post-menopausal women with previous fracture.
The F symbol is a prompt for health professionals to refer to an information sheet relevant to the development of the Team Care Arrangement and/or GP Management Plan for people with osteoporosis.

Patient’s Name: <<Patient Demographics:Full Name>>	Date of Birth: <<Patient Demographics:DOB>>	

Contact Details:	Medicare or Private Health Insurance Details:	
<<Patient Demographics:Full Address>>	<<Patient Demographics:Medicare Number>>
<<Patient Demographics:Health Insurance>>	

Details of Patient’s Usual GP:	Details of Patient’s Carer (if applicable):	
<<Doctor:Name>>
<<Doctor:Full Address>>	

Date of last Care Plan/Team Care Arrangements (if done):  <<Date of last Care Plan/TCA>>

Other notes or comments relevant to the patient’s Team Care Arrangements: 

	

PAST MEDICAL HISTORY

FAMILY HISTORY

<<Clinical Details:Family History>>

MEDICATIONS 

<<Clinical Details:Medication List>>

ALLERGIES

 Patient’s Name: <<Patient Demographics:Full Name>>

TEAM CARE ARRANGEMENTS –Osteoporosis	
This Team Care Arrangement can be used for adult patients with established osteoporosis, who may require multidisciplinary care eg. post-menopausal women with previous fracture.
The F symbol is a prompt for health professionals to refer to an information sheet relevant to the development of the Team Care Arrangement and/or GP Management Plan for people with osteoporosis.

Goals - changes to be achieved	Required treatments and services including patient actions	Specific arrangements for treatments/services (when, who, and contact details)	
1. General			
Patient to have a clear understanding of osteoporosis and the patient’s role in self management.	Patient education	-GP
-Physiotherapist	
Optimal pain management	Development of pain management program suitable to needs of patient
Options: analgesia, counselling, physiotherapy, occupational therapy	-GP
-Physiotherapist 
-Occupational therapist/counselling	
2. Lifestyle			
Maintain healthy diet and weight	 -Assess dietary calcium & vitamin D intake.
-Provide patient education re adequate intake & sources of calcium & vitamin D, including adequate sun exposure F
-Consider calcium and vitamin D supplements if intake inadequate  F	-GP
-Dietitian
	
Increase / maintain physical activity.

Recommendations: F
 	Patient education re specific exercises F

	-GP
-Physiotherapist or Exercise physiologist
-Occupational therapist
-Orthopaedic surgeon	
Optimise mobility / reduce risk of falls.	Targeted & multi-faceted falls prevention programs  F	-GP
-Occupational therapist
-Podiatrist
-Pharmacists as part of HMR or RMMR	
Smoking cessation	Smoking cessation program – drug and non-drug options	-GP
-Quit program/support group (ph 131 848)	
4. Medication management	-Ensure correct use of medications, minimise side effects, review compliance with medications & duration of therapy. F
-Undertake Home Medicine Review 	-GP
-Pharmacist as part of HMR or RMMR
	
5. Psychosocial			
Ensure mental well-being	Management of psychological disease burden. 	-Psychologist
-Counsellor / social worker
-Support groups/services	
Optimise / preserve independence through assistance with daily living activities	Linkages to community services	-GP
-Support services/ groups	

Copy of Team Care Arrangements offered to patient?  <<Copy of TCA offered to patient?>>

Team Care Arrangements added to the patient’s records?  <<TCA added to patient record?>>

Copy / relevant parts of the Team Care Arrangements supplied to other providers?  <<Copy of TCA supplied to other providers?>>

Referral forms for Medicare allied health and dental care services completed?  <<Referral forms for Medicare AHPs completed?>>
[For referral forms call 1800 067 307, go to www.hic.gov.au/providers/forms or look under "Supplied" templates] 

Date service was completed:  <<Date service completed>>	Proposed Review Date:  <<Review date (6 months recommended)>>	

I have explained the steps and any costs involved, and the patient has agreed to proceed with the Team Care Arrangements.  <<Steps and costs explained, patient agreed>>
The patient also agrees to the involvement of other health providers and to share their clinical information (without / with restrictions).  <<Patient agrees to AHPs and sharing information>>

 GP’s Signature:  ________________________________________________	Date:___________________