The following is a summary of “Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases,” published in the March 2024 issue of Rheumatology by Fuller et al.

Researchers conducted a retrospective study to investigate the feasibility and acceptability of personalized, risk-stratified monitoring for target-organ toxicity in adult patients with immune-mediated inflammatory diseases receiving immune-suppressing treatment(s). 

They invited adults aged 18 or older who had been on immunosuppressive treatments for at least six months and healthcare professionals (HCPs) experienced in prescribing and/or monitoring such drugs to engage in individual, remote, one-on-one, semi-structured interviews. These interviews, facilitated by a qualified qualitative researcher, delved into participants’ perspectives and experiences regarding current monitoring practices and their willingness to embrace a proposed risk-stratified monitoring strategy. Verbatim transcripts of the interviews were generated and subjected to inductive thematic analysis using NVivo software.

The result showed that out of 18 patients and 13 HCPs interviewed, both groups agreed on the current burden posed by frequent blood tests for monitoring immune-suppressing drugs. Given the rarity of abnormalities during long-term treatment, they considered the current frequency unnecessary and wasteful of healthcare resources. Most participants agreed that reducing the frequency of blood tests from every three months to every six months or annually would be acceptable, contingent upon certain conditions. These conditions included allowing clinicians and patients to jointly determine the appropriate monitoring frequency based on individual risk profiles, the ability to adjust the frequency as needed, and support from specialist societies and healthcare providers like the National Health Service.

Investigators concluded that patients and HCPs approve of risk-based monitoring schedules, suggesting guidelines incorporate this approach for blood test frequency.

Source: academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keae175/7628623