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Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with
Amy Fuller1, Jennie Hancox2,3, Hywel C Williams3
1Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Rheumatology (Oxford, England)
|March 14, 2024
Summary
Patients and healthcare professionals find a risk-stratified approach to monitoring immune-suppressing drugs acceptable. This personalized plan for monitoring target-organ toxicity could reduce burdensome blood tests.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Immune-mediated inflammatory diseases (IMIDs) require long-term immune-suppressing treatments.
- Current monitoring protocols for target-organ toxicity involve frequent blood tests, which can be burdensome.
Purpose of the Study:
- To explore the acceptability of an individualized, risk-stratified monitoring approach for target-organ toxicity in adult patients on immune-suppressing therapy.
- To assess patient and healthcare professional perspectives on current monitoring practices and a proposed risk-stratified plan.
Main Methods:
- Qualitative study involving semi-structured interviews with 18 adult patients and 13 healthcare professionals (HCPs).
- Participants were on immune-suppressing treatment for at least six months.
- Interviews explored experiences with current monitoring and acceptability of a risk-stratified plan, analyzed thematically.
Main Results:
- Both patients and HCPs found frequent blood tests reassuring but burdensome and resource-intensive.
- Participants agreed that monitoring intervals could be extended (e.g., to six-monthly or annually) based on individual risk profiles.
- Acceptance was contingent on clinician/patient autonomy, flexibility for risk changes, and endorsement from professional bodies.
Conclusions:
- A risk-stratified monitoring approach is acceptable to both patients and HCPs.
- Guideline developers should consider these findings to optimize blood test monitoring intervals for patients on immune-suppressing drugs.
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