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  1. Article ; Online: OpenSAFELY: The impact of COVID-19 on azathioprine, leflunomide and methotrexate monitoring, and factors associated with change in monitoring rate.

    Brown, Andrew D / Fisher, Louis / Curtis, Helen J / Wiedemann, Milan / Hulme, William J / Speed, Victoria / Hopcroft, Lisa E M / Cunningham, Christine / Costello, Ruth E / Galloway, James B / Russell, Mark D / Bechman, Katie / Kurt, Zeyneb / Croker, Richard / Wood, Chris / Walker, Alex J / Schaffer, Andrea L / Bacon, Seb C J / Mehrkar, Amir /
    Hickman, George / Bates, Chris / Cockburn, Jonathan / Parry, John / Hester, Frank / Harper, Sam / Goldacre, Ben / MacKenna, Brian

    British journal of clinical pharmacology

    2024  

    Abstract: Aims: The COVID-19 pandemic created unprecedented pressure on healthcare services. This study investigates whether disease-modifying antirheumatic drug (DMARD) safety monitoring was affected during the COVID-19 pandemic.: Methods: A population-based ... ...

    Abstract Aims: The COVID-19 pandemic created unprecedented pressure on healthcare services. This study investigates whether disease-modifying antirheumatic drug (DMARD) safety monitoring was affected during the COVID-19 pandemic.
    Methods: A population-based cohort study was conducted using the OpenSAFELY platform to access electronic health record data from 24.2 million patients registered at general practices using TPP's SystmOne software. Patients were included for further analysis if prescribed azathioprine, leflunomide or methotrexate between November 2019 and July 2022. Outcomes were assessed as monthly trends and variation between various sociodemographic and clinical groups for adherence with standard safety monitoring recommendations.
    Results: An acute increase in the rate of missed monitoring occurred across the study population (+12.4 percentage points) when lockdown measures were implemented in March 2020. This increase was more pronounced for some patient groups (70-79 year-olds: +13.7 percentage points; females: +12.8 percentage points), regions (North West: +17.0 percentage points), medications (leflunomide: +20.7 percentage points) and monitoring tests (blood pressure: +24.5 percentage points). Missed monitoring rates decreased substantially for all groups by July 2022. Consistent differences were observed in overall missed monitoring rates between several groups throughout the study.
    Conclusion: DMARD monitoring rates temporarily deteriorated during the COVID-19 pandemic. Deterioration coincided with the onset of lockdown measures, with monitoring rates recovering rapidly as lockdown measures were eased. Differences observed in monitoring rates between medications, tests, regions and patient groups highlight opportunities to tackle potential inequalities in the provision or uptake of monitoring services. Further research should evaluate the causes of the differences identified between groups.
    Language English
    Publishing date 2024-04-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.16062
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: OpenSAFELY: The impact of COVID-19 on azathioprine, leflunomide, and methotrexate monitoring, and factors associated with change in monitoring rate

    The OpenSAFELY Collaborative / Brown, Andrew D. / Fisher, Louis / Curtis, Helen J. / Wiedemann, Milan / Hulme, William J. / Hopcroft, Lisa E.M. / Cunningham, Christine / Speed, Victoria / Costello, Ruth E. / Galloway, James B. / Russell, Mark D. / Bechman, Katie / Kurt, Zeyneb / Croker, Richard / Wood, Chris / Walker, Alex J. / Schafer, Andrea L. / Bacon, Seb C.J. /
    Mehrkar, Amir / Hickman, George / Bates, Chris / Cockburn, Jonathan / Parry, John / Hester, Frank / Harper, Sam / Goldacre, Ben / MacKenna, Brian

    medRxiv

    Abstract: Background: The COVID-19 pandemic created unprecedented pressure on healthcare services. This study aimed to investigate if disease-modifying anti-rheumatic drug (DMARD) safety monitoring was affected during the COVID-19 pandemic. Methods: A population- ... ...

    Abstract Background: The COVID-19 pandemic created unprecedented pressure on healthcare services. This study aimed to investigate if disease-modifying anti-rheumatic drug (DMARD) safety monitoring was affected during the COVID-19 pandemic. Methods: A population-based cohort study was conducted with the approval of NHS England, using the OpenSAFELY platform to access electronic health record data from 24.2 million patients registered at general practices using TPP9s SystmOne software. Patients were included for further analysis if prescribed azathioprine, leflunomide, or methotrexate between November 2019 and July 2022. Outcomes were assessed as monthly trends and variation between various sociodemographic and clinical groups for adherence with standard safety monitoring recommendations. Findings: An acute increase in the rate of missed monitoring occurred across the study population (+12.4 percentage points) when lockdown measures were implemented in March 2020. This increase was more pronounced for some patient groups (70-79 year-olds: +13.7 percentage points; females: +12.8 percentage points), regions (North West: +17.0 percentage points), medications (Leflunomide: +20.7 percentage points), and monitoring tests (Blood Pressure: +24.5 percentage points). Missed monitoring rates decreased substantially for all groups by July 2022. Substantial and consistent differences were observed in overall missed monitoring rates between several groups throughout the study. Interpretation: DMARD monitoring rates temporarily deteriorated during the COVID-19 pandemic. Deterioration coincided with the onset of lockdown measures, with monitoring rates recovering rapidly as lockdown measures were eased. Differences observed in monitoring rates between medications, tests, regions, and patient groups, highlight opportunities to tackle potential inequalities in the provision or uptake of monitoring services. Further research should aim to evaluate the causes of the differences identified between groups. Funding: None. Keywords COVID-19, electronic health records, general practice, primary health care, antirheumatic agents, methotrexate, azathioprine, leflunomide.
    Keywords covid19
    Language English
    Publishing date 2023-06-07
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2023.06.06.23290826
    Database COVID19

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