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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Routine Use of Quantitative Disease Activity Measurements among US Rheumatologists: Implications for Treat-to-target

Jeffrey R Curtis1,2, Lang Chen3,4, Maria I Danila3,4

  • 1From University of Alabama at Birmingham, Birmingham, Alabama; Baylor Research Institute, Dallas, Texas, USA. jrcurtis@uabmc.edu.

The Journal of Rheumatology
|November 17, 2017
PubMed
Summary

Quantitative measurements for rheumatoid arthritis (RA) are underutilized by US rheumatologists due to time and electronic barriers. Increased quantitative data may influence treatment decisions for RA patients.

Keywords:
RHEUMATOID ARTHRITISRHEUMATOLOGYSURVEY

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Area of Science:

  • Rheumatology
  • Clinical Practice
  • Health Outcomes

Background:

  • Quantitative measurements in rheumatoid arthritis (RA) care are crucial for objective disease assessment.
  • Limited attention has been given to real-world practices and attitudes concerning these quantitative measurements.
  • Understanding current utilization patterns is essential for improving RA management.

Purpose of the Study:

  • To investigate the reasons behind the limited attention to quantitative measurements in clinical practice for rheumatoid arthritis.
  • To assess the current use of quantitative measurement tools among US rheumatologists.
  • To explore the impact of quantitative data on treatment decisions in RA.

Main Methods:

  • An email survey was conducted among US rheumatologists to self-report their use of quantitative measurements.
  • Respondents were asked about their practices, attitudes, and reasons for not using quantitative tools.
  • Simulated case scenarios were used to evaluate the influence of quantitative information on treatment choices.

Main Results:

  • Among 439 respondents, 58% reported using quantitative measurements, often in group practices and with tumor necrosis factor inhibitors.
  • The Health Assessment Questionnaire (35.5%) and Routine Assessment of Patient Index Data 3 (27.1%) were the most common tools.
  • Primary barriers included time constraints and lack of electronic availability.
  • Increased quantitative information in simulated cases raised the likelihood of changing disease-modifying antirheumatic drugs or biologics.

Conclusions:

  • Routine use of quantitative measurements for rheumatoid arthritis patients in the US is increasing but remains low.
  • Barriers such as time and electronic availability hinder widespread adoption.
  • Quantitative data has the potential to influence clinical decision-making and treatment selection in RA management.