ArticleClinical rheumatology2025
Optimizing laboratory medication safety monitoring in patients with juvenile idiopathic arthritis to advance value-based care.
Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
INTRODUCTION/
objectivesMost children with juvenile idiopathic arthritis (JIA) are treated with medications that require safety monitoring labs. Recommended testing includes a creatinine level. However, 87.5% of our visits had a basic metabolic panel (BMP) done. The difference in charges for ordering a serum creatinine versus a BMP is $31, and the difference in matched net revenue per unit is $12.09. Our aim was to increase the ordering of a creatinine rather than a BMP in patients with non-systemic JIA needing methotrexate, leflunomide, and/or biologic medication safety lab monitoring in the Rheumatology Clinic from 12.5 to 80% in 8 months.
methodWe utilized quality improvement tools, incorporated this project in our pre-visit planning process, provided physician education, and made updates to our electronic medical record (EMR) order sets. We tracked the percent of patients with JIA taking the pertinent medications who had a creatinine checked rather than a BMP on a run chart to review performance over time.
resultsOur baseline median was 12.5% of visits having a creatinine alone checked instead of a BMP (Fig. 1). We had two shifts in our data with a final center line of 99%. There were no unintended consequences noted during our project.
conclusionsOur project optimized medication safety monitoring in patients with JIA by eliminating unnecessary tests to save costs and advance value-based care. Our interventions of education and EMR modifications allowed for standardization of laboratory test ordering. We plan to expand this project to other medications and other diseases to further decrease costs without sacrificing patient safety. Key Points • Most of our patients with JIA that require medication safety monitoring had a basic metabolic panel obtained rather than the recommended serum creatinine. • We significantly increased ordering of a clinically recommended and more cost-effective serum creatinine alone for screening of renal function through quality improvement methodology, physician education, pre-visit planning, and electronic medical record modifications.
Indexed as
Identifiers
39853558What OpenQuestion holds
Registered trials
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.