Evidence map›Paper›PMID 38483276›Full record

ArticleRheumatology (Oxford, England)2025

Patient and health professional views on risk-stratified monitoring of immune-suppressing treatment in adults with inflammatory diseases.

Amy Fuller, Jennie Hancox, Hywel C Williams, Tim Card, Maarten W Taal, Guruprasad P Aithal, Christopher P Fox, Christian D Mallen, James R Maxwell, Sarah Bingham and 2 more

Abstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Amy FullerAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0002-9669-1816
Jennie HancoxSchool of Health Sciences, Loughborough University, Loughborough, UK.
Hywel C WilliamsLifespan and Population Health, University of Nottingham, Nottingham, UK.
Tim CardLifespan and Population Health, University of Nottingham, Nottingham, UK.
Maarten W TaalCentre for Kidney Research and Innovation, Translational Medical Sciences, University of Nottingham, Derby, UK.ORCID 0000-0002-9065-212X
Guruprasad P AithalNottingham Digestive Diseases Centre, Translational Medical Sciences, University of Nottingham, Nottingham, UK.
Christopher P FoxSchool of Medicine, University of Nottingham, Nottingham, UK.
Christian D MallenPrimary Care Centre Versus Arthritis, Keele University, Keele, UK.ORCID 0000-0002-2677-1028
James R MaxwellDepartment of Rheumatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Sarah BinghamDepartment of Rheumatology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK.
Kavita VedharaLifespan and Population Health, University of Nottingham, Nottingham, UK.
Abhishek AbhishekAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.

Funding

AstraZenecaDepartment of Health and Social CareNational Institute for Health and Care Research-Health Technology Assessment NIHR130580
6 · The paper itself

Abstract

objectiveTo 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).

methodsAdults (≥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.

resultsEighteen 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.

conclusionA 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.

Indexed as

Attitude of Health PersonnelDrug MonitoringHealth PersonnelImmunosuppressive AgentsAdultAgedFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchRisk AssessmentImmunosuppressive Agentsblood monitoringimmune-mediated inflammatory diseasequalitativesteroid sparing drugs

Identifiers

PMID38483276
PMCPMC11879332

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.