Session Information
Session Type: Abstract Submissions (ARHP)
Background/Purpose: Medication assessment tools can be defined as evidence-based instruments intended for the evaluation of prescribing trends and monitoring of adherence to established guidelines. Medication assessment tools have been specifically designed and implemented in the management of heart failure, coronary artery disease, asthma, diabetes mellitus and pain management in cancer. The objective of the study was to develop and validate medication assessment tools specific for rheumatoid arthritis (RA) in order to provide a systematic and standardised instrument ensuring evidence based practice in RA management.
Methods:
Guidelines, recommendations and standards on RA and its management as set out by the American College of Rheumatology (ACR), the European League against Rheumatism (EULAR), the British Society for Rheumatology (BSR) and the National Institute for Clinical Excellence (NICE) were used to develop the Rheumatoid Arthritis Medication Assessment Tool (RhMAT). The summary of product characteristics for each drug included in the RhMAT were used as reference criteria. The medication assessment tool was designed in the form of a table bearing in mind that the tool will be used in a busy clinic where time can be limited. The RhMAT was validated by an expert panel who assessed the practicality, presentation, robustness and validity of the tool according to the data provided.
Results: The developed RhMAT was designed in the form of a table consisting of 11 separate sections dealing with general criteria for RA, use of analgesics, methotrexate, sulphasalazine, hydroxychloroquine, leflunomide, gold injections, general prebiologic screening, biologic therapy, use of glucocorticoids, remission cases . Table1 is an extract from the RhMAT and outlines part of the methotrexate section.
Table 1. Extract from “RhMAT”
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Methotrexate |
N/A |
Yes |
No justified |
No unjustified |
Insufficient Data |
Comments |
Reference |
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1 |
Used as first line DMARD in the absence of contraindications |
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2 |
Pre-treatment screening including Chest X ray, CBC, ESR, CRP, LFTs, U&Es, Creatinine have been completed |
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3 |
Regular monitoring according to monitoring protocol schedule including mouth ulcers, nausea and vomiting and dyspnoea |
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4 |
Contraindications namely pregnancy, breastfeeding, active local or systemic infection, bone marrow suppression excluded |
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5 |
The patient has been prescribed methotrexate at a dose that is unambiguously expressed as a ONCE A WEEK administration |
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The expert panel validating the developed RhMAT consisted of 3 consultant rheumatologists, 2 academic pharmacists, an academic science professor and a rheumatology nurse specialist. Following the expert panel review one of the statements was split into 2 separate statements to increase specificity. This was repeated for another statement.
Conclusion:
Medication assessment tools have been shown to be effective instruments providing a one-atop measure which can be used both as a clinical audit tool as well as a tool which supports best practice for a number of chronic diseases. The developed RhMAT is a comprehensive, user-friendly checlist tool designed to be used in a busy adult rheumatology out-patient clinic ensuring safer prescribing of rheumatological drugs.
Disclosure:
L. Grech,
None;
B. Coleiro,
None;
A. Serracino Inglott,
None;
L. M. Azzopardi,
None;
V. Ferrito,
None;
A. A. Borg,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/development-and-validation-of-medication-assessment-tools-specific-for-rheumatoid-arthritis/