| Title: |
Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases |
| Authors: |
Fuller, Amy; Hancox, Jennie; Williams, Hywel C.; Card, Tim; Taal, Maarten W.; Aithal, Guruprasad P.; Fox, Christopher P.; Mallen, Christian D.; Maxwell, James R.; Bingham, Sarah; Vedhara, Kavita; Abhishek, Abhishek |
| Publisher Information: |
Oxford University Press |
| Publication Year: |
2025 |
| Collection: |
Cardiff University: ORCA (Online Research @ Cardiff) |
| Description: |
Objective: To explore the acceptability of an individualised risk-stratified approach to monitoring for target-organ toxicity in adult patients with immune-mediated inflammatory diseases established on immune-suppressing treatment(s). Methods: Adults (≥18 years) taking immune-suppressing treatment(s) for at-least six months, and healthcare professionals (HCPs) with experience of either prescribing and/or monitoring immune-suppressing drugs were invited to participate in a single, remote, one-to-one, semi-structured interview. Interviews were conducted by a trained qualitative researcher and explored their views and experiences of current monitoring and acceptability of a proposed risk-stratified monitoring plan. Interviews were transcribed verbatim and inductively analysed using thematic analysis in NVivo. Results: Eighteen patients and 13 HCPs were interviewed. While participants found monitoring of immune-suppressing drugs with frequent blood-tests reassuring, the current frequency of these was considered burdensome by patients and HCPs alike, and to be a superfluous use of healthcare resources. Given abnormalities rarely arose during long-term treatment, most felt that monitoring blood-tests were not needed as often. Patients and HCPs found it acceptable to increase the interval between monitoring blood-tests from three-monthly to six-monthly or annually depending on the patients’ risk profiles. Conditions of accepting such a change included: allowing for clinician and patient autonomy in determining an individuals’ frequency of monitoring blood-tests, the flexibility to change monitoring frequency if someone’s risk profile changed, and endorsement from specialist societies and healthcare providers such as the National Health Service. Conclusion: A risk-stratified approach to monitoring was acceptable to patients and HCPs. Guideline groups should consider these findings when recommending blood-test monitoring intervals. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://orca.cardiff.ac.uk/id/eprint/167316/8/keae175.pdf; Fuller, Amy, Hancox, Jennie, Williams, Hywel C., Card, Tim, Taal, Maarten W., Aithal, Guruprasad P., Fox, Christopher P., Mallen, Christian D., Maxwell, James R., Bingham, Sarah, Vedhara, Kavita https://orca.cardiff.ac.uk/view/cardiffauthors/A2867160K.html and Abhishek, Abhishek 2025. Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases. Rheumatology 64 , pp. 969-975. 10.1093/rheumatology/keae175 https://doi.org/10.1093/rheumatology%2Fkeae175 file https://orca.cardiff.ac.uk/id/eprint/167316/8/keae175.pdf |
| DOI: |
10.1093/rheumatology/keae175 |
| Availability: |
https://orca.cardiff.ac.uk/id/eprint/167316/; https://doi.org/10.1093/rheumatology/keae175; https://orca.cardiff.ac.uk/id/eprint/167316/8/keae175.pdf |
| Rights: |
cc_by_4_0 |
| Accession Number: |
edsbas.54C5291E |
| Database: |
BASE |