Hospital / Specialist GP / Practice Baseline monitoring of (tick if appropriate) Ongoing monitoring FBC WBC Platelets Urinalysis Side effects U&Es LFTs Urinalysis for Proteinuria & Blood Symptom Control Differential WBC Creatinine TPMT BP Chest X-Ray Specialist GP Lead Monitoring Monthly FBC & LFTs Continued monitoring (tick if appropriate) 6-Monthly U&Es 4-Weekly FBC 4-Weekly Urinalysis Ask about respiratory symptoms at FBC, WBC & Urinalysis before each injection monitoring Fortnightly FBC, U&E & Urinalysis for first 3 Months then 4 weeks 2-Weekly FBC, WBC & LFT for 12 weeks, then Every 3 months for first year then 6-Monthly thereafter (or 1 month after dose increase) Weekly FBC & LFTs for first 6 weeks then monthly 6-Monthly U&Es Fortnightly FBC LFT U&E for 6 weeks After any dose increase Monthly FBC, Differential WBC, LFT & BP for First 6 months then every 8 weeks Fortnightly FBC, WBC, U&Es & LFTs for first 6 weeks then monthly thereafter Ask patient about respiratory symptoms MEDICATION RESPONSIBILITY / ACTION IN CASE OF PROBLEMS Contact: Office Hours Specialist – Telephone Tel DRI Rheumatology 01302 553281 Out of On-call DRI Tel: 01302 366666 – . To be completed by GP and returned to specialist I agree to this shared care proposal and am willing to prescribe from (Start date) GP name (printed) GP signature Date NB: Please call Specialist if further information or support is required prior to signing. ROUTINE MONITORING TO BE CONDUCTED UNDER SHARED CARE ARRANGEMENTS DRUG CONSULTANT GP
Hospital / Specialist Baseline monitoring of (tick if appropriate) FBC WBC Platelets Urinalysis U&Es LFTs Urinalysis for Proteinuria & Blood Differential WBC Creatinine TPMT BP Chest X-Ray Continued monitoring (tick if appropriate) 4-Weekly FBC 4-Weekly Urinalysis FBC, WBC & Urinalysis before each injection Fortnightly FBC, U&E & Urinalysis for first 3 Months then 4 weeks 2-Weekly FBC, WBC & LFT for 12 weeks, then Every 3 months for first year then 6-Monthly thereafter (or 1 month after dose increase) Weekly FBC & LFTs for first 6 weeks then monthly 6-Monthly U&Es Fortnightly FBC LFT U&E for 6 weeks After any dose increase Monthly FBC, Differential WBC, LFT & BP for First 6 months then every 8 weeks Fortnightly FBC, WBC, U&Es & LFTs for first 6 weeks then monthly thereafter Ask patient about respiratory symptoms GP / Practice Ongoing monitoring Side effects Symptom Control Specialist GP Lead Monitoring Monthly FBC & LFTs 6-Monthly U&Es Ask about respiratory symptoms at monitoring MEDICATION RESPONSIBILITY / ACTION IN CASE OF PROBLEMS Contact: Office Hours – Specialist Telephone DRI Rheumatology Tel 01302 553281 Out of – On-call DRI Tel: 01302 366666 . To be completed by GP and returned to specialist I agree to this shared care proposal and am willing to prescribe from (Start date) GP name (printed) GP signature Date NB: Please call Specialist if further information or support is required prior to signing. ROUTINE MONITORING TO BE CONDUCTED UNDER SHARED CARE ARRANGEMENTS DRUG CONSULTANT GP
Inflammatory%20arthritis%20Proforma.doc.docx