Listed below are the locally agreed shared care arrangements. Note unless otherwise stated they are not applicable to * renal patients, paediatrics and some ophthalmology patients. If required, monitoring is arranged on a case-by case basis by the ophthalmology specialists
* GP practices should be aware that they are only required to undertake blood monitoring for renal patients in exceptional circumstances. The renal physicians will contact the practice directly to arrange this. Excessive venopuncture may predispose patients to poor venous access later in treatment and should be avoided, see Renal SCAs.
DMARDs - Shared Care Arrangements
Monitoring schedules for DMARDs (updated March 2022)
A new guideline for the monitoring schedule for DMARDs has been agreed (March 2022). The schedule is independent of indication and has been agreed with the specialties (Rheumatology/Ophthalmology/Gastroenterology/Dermatology/Paediatrics) in Secondary care. The only exception being renal patients who will continue to be managed for blood test/monitoring by the specialist service.
Specialties will contact General Practices on an individual patient basis for any patients that, due to their specific circumstances, require additional monitoring outwith this schedule. This should be required only in exceptional circumstances. It is intended that this guidance will reduce monitoring requirements for stable patients who have been on treatment for some time.
- Monitoring schedules for DMARDs - NOTE: This supersedes the monitoring schedules specified in relevant Shared Care Arrangements/Protocols.
- Azathioprine
- Ciclosporin oral
- Leflunomide
- Mercaptopurine
- Methotrexate Injection (Paediatric)
- Methotrexate Injection
- Methotrexate oral
- Mycophenolate mofetil
- Sulfasalazine
- Tacrolimus oral
Non-DMARD - Share Care Arrangements
- Amiodarone (adults only)
- Clozapine:
- Denosumab 120mg injection (Xgeva )
- Dronedarone (adults only)
- Lithium
- Penicillamine
- Tenofovir