How I helped make antirheumatic drug monitoring safer in my GP practice

摘要

Disease-modifying antirheumatic drugs (DMARDs) are among the most high-risk medicines prescribed in primary care. By suppressing the immune response to inflammation in autoimmune and related conditions, they increase susceptibility to infections, which tend to be more severe. In addition, some of the drugs are directly hepatotoxic. DMARDs are typically initiated by a specialist in secondary care, sometimes under a shared care guideline, with responsibility for subsequent prescribing and monitoring then passed to GPs. Patients on these drugs need regular blood tests to ensure that the treatment is not doing more harm than good. Following titration, the frequency of monitoring will usually reduce.