Blood monitoring for biologic and DMARD treatment
While you are taking medication for your rheumatology condition, it is important that your blood tests are closely monitored. At Gloucestershire Hospitals NHS Foundation Trust, we use a computer system which we call DAWN, (after the company who manage the system). This page aims to explain why we use this system and how it can help.
Blood monitoring
When you begin taking your medication, your personal details will be entered into the DAWN system. This will then allow your blood test results to be entered into the system and monitored.
The Rheumatology team will monitor the system daily (Monday to Friday) and arrange any treatments necessary if there are any abnormal results.
For more information about how your personal information is stored and kept safe at Gloucestershire Hospitals NHS Foundation Trust, please read our ‘Privacy notice’ by visiting: www.gloshospitals.nhs.uk/privacy-notice
While you are taking the medication prescribed by the rheumatology team, it is important to have regular blood tests. If we do not have the necessary blood samples, your future prescriptions may be delayed.
Medication
The Rheumatology team will be responsible for prescribing your medication and monitoring your blood results during treatment.
Some of the prescribed treatments require blood tests to be taken at different times. These can range from monthly to every 3 months.
Your GP will receive copies of each of your clinic consultation letters. The letters will detail any discussions that took place at the consultation and give information about when you will need blood tests. You will also receive a copy of these letters.
If the medication you have been prescribed is a Disease-Modifying Anti Rheumatic Drug (DMARD), we will monitor your blood tests for the first 3 months of your treatment. After this, your GP will take over your care.
The monitoring starts with blood tests every 2 weeks and will continue for the first 6 weeks of your treatment.
If your blood test results continue to be satisfactory, you will then have monthly blood tests until your GP takes over your care at 3 months. Further blood tests will then be arranged and the results will be monitored and treatment managed at your GP’s surgery.
The Rheumatology team will provide all prescriptions until we have confirmation from your GP that they are satisfied that you are stable enough for them to take over your care.
The main DMARDs which will need monitoring include:
- Methotrexate
- Sulfasalazine
- Leflunomide
- Azathioprine
- Mycophenolate mofetil
Where can I have a blood test?
Blood tests can be taken at your GP’s surgery. Sometimes your GP will provide the blood form, if not, blood forms can be posted to you from the Rheumatology department.
To request a blood form, please email the Rheumatology Admin team at ghn-tr.rheumybloodsandbiologics@nhs.net or call the Rheumatology Nurse Advice Line on 0300 422 6412.
Your GP will be aware of the blood tests needed as they will have received copies of your clinic consultation letters containing this information.
Blood tests can also be arranged at one of the drop-in clinics at West Block Out Patient Department, Cheltenham General Hospital or the Edward Jenner Unit, Gloucestershire Royal Hospital, between the hours of 8:30am and 4:30pm, Monday to Friday.
Alternatively, blood samples can be taken at the Quayside Community Diagnostic Centre, Monday to Friday, 9:00 am to 5:00 pm (appointments only). Appointments can be arranged by contacting the Diagnostic Centre on 0300 422 3900.
The Rheumatology team will let you know of any abnormal blood results which may need us to make changes to your medication. Your GP will be responsible for this once they have taken over your care.
If you miss a blood test
We send out automated reminders when you are due for a blood test. If you miss a blood test, the computer system will alert us. Repeat prescriptions cannot be issued until you have had a blood test and the results received.
Biologic prescriptions using a Homecare Delivery Service
For patients having their prescriptions delivered from a Homecare Delivery Service, your medication will be prescribed by the Rheumatology team. Your GP will be aware of your treatment but the Rheumatology team are responsible for monitoring your blood test results and making sure that your prescriptions are repeated. Your prescription will be sent to the Homecare Delivery company via the hospital pharmacy.
The Homecare Delivery company will call you to arrange your first delivery. You will then get a further call from a qualified nurse from the Homecare Delivery company, to arrange training in biologic therapy injections (if this has been requested).
Before each delivery, the Homecare Delivery company will contact you to arrange a delivery slot.
The Homecare Delivery company will order and deliver all future prescriptions of your biologic therapy - you will not need to arrange this.
When you have received your first dose of biologic therapy, please email or telephone the Rheumatology department, using the details in the next section, to let them know. This will generate your follow-up appointment which will be arranged for 3 months after starting the biologic therapy.
Contact information
For prescriptions, please email:
ghn-tr.dmards.rheumatology@nhs.net
For blood form requests email:
ghn-tr.rheumybloodsandbiologics@nhs.net
For all other queries, contact the:
Nurse Advice Line
Tel: 0300 422 6412
Monday to Friday, 10:00am to 1:45pm
Email: ghn-tr.rheumadvice@nhs.net