Supplementary information files for "Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases"
Supplementary files for article "Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases"
Objective To explore the acceptability of an individualized 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 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 health care professionals. Guideline groups should consider these findings when recommending blood-test monitoring intervals.
©The Authors, CC BY 4.0
Funding
The development of risk-stratified, cost-effective, and acceptable blood-test monitoring strategies for inflammatory conditions treated with commonly used immune suppressing drugs: a multi-method study using evidence synthesis, modelling and qualitative research
NIHR Evaluation Trials and Studies Coordinating Centre
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