Regular blood tests sound drastic, but they are a simple way of avoiding future problems associated to your arthritis and connective tissue disease and medications prescribed to treat these conditions.
The main purpose is to pick up potential side effects from long term medication early, but they also assess disease activity such as inflammation.
The frequency of tests depends on the drug and how long it has been taken and the Rheumatology Team will let you know the frequency of the blood tests required
- Blood test for DMARDS require fortnightly for until you have been on a stable dose of the medication for 6 weeksthen blood tests monthly for 3 months , then finally reducing to every 3 months, as long as there have been no abnormal results requiring a change in medication
- Blood test for Hydroxychloroquine on its own requires pre appointment blood test only
- Blood tests for Biologic Therapies monthly for 3 months , then finally reducing to every 3 months, as long as there have been no abnormal results requiring a change in medication
- Blood tests for Janus kinase (JAK) inhibitors require fortnightly for until you have been on a stable dose of the medication for 6 weeksthen blood tests monthly for 3 months , then finally reducing to every 3 months, as long as there have been no abnormal results requiring a change in medication
Whilst taking your medication, it is essential for your safety, to have regular blood tests. (The only exception is if you have been prescribed Hydroxychloroquine/Plaquenil on its own)
This is usually because your health care professional need to accurately interpret your test results. This is quite normal and can happen for a variety of reasons. So, it’s not an immediate cause for concern. You will receive a letter or a telephone/ Text Message requesting a further blood test is undertaken
It might be that your results are borderline, i.e. on the threshold of two different readings, or it could be that your results are abnormal.
Some times more tests are needed to get a full picture of your health in line with previous blood test results
Other reasons include:-
Sample rejected
Missing blood test sample bottles
Underfilled sample bottled
Out of date sample bottle being used- some of the blood sample bottles have special chemicals within the bottle, if the sample out of date, the sample result may be affected
In correct information on blood test form or on the sample bottle i.e., full name, date of birth, hospital/NHs Number etc
Regardless, you must take a repeat test if requested. It will help your health care team better understand, treat any health problems you may have.
It would be recommended that if possible that you do get any updated blood test if you are having a flare of your arthritis/ connective tissue disease, as this may help when reviewing you and making a new management plan.
The Department of Rheumatology will provide you with the first 3 months of blood tests forms, there after you can ask GP Practice team for further blood test forms
Yes, most general blood test results will be ready within 24 hours of the blood test sample received, although some specialist blood tests may not be available for a few weeks.
GP'S Practices using local pathology service and blood tests taken at the local hospitals will be uploaded to a IT system called Apex and are available to your GP Practice through two other IT Systems ICE and The Care and Health Information Exchange (CHIE) is a secure system which shares health and social care information from GP surgeries, hospitals, community and mental health, social services and others
If your blood test samples are sent to Southampton, Winchester, Guilford, Basingstoke, Isle of wight or Chichester , your GP Practice will receive a copy of the blood test results, however the Department of Rheumatology may need to liaise with your GP surgery or the other hospital to access the results.
At the Portsmouth Hospitals University NHS Trust- Department of Rheumatology, we have a specialized computer system for monitoring blood results, (DAWN). Once you have started a DMARD, Biologics, JAKs medication your details will be entered onto the DAWN system and your blood results will then be monitored.
The Rheumatology Department will also inform you and your GP practice of any abnormal blood results which may need us to make changes to your medication.
If you miss a blood test, the system will alert us.
The Department initially will send you a text message, followed by a letter to remind you to have a blood test. If you still do not have your blood tests done after the 1st letter a second letter will be sent to you and the rheumatology advising you that we recommend that you stop your medication, and no further prescription will be issued either by the Rheumatology Department or your GP until you have had a blood test completed.
If you have received the second letter for your :-
DMARD treatment - you will need to let your GP Practice know that you have had a blood test so that they can restart your prescriptions (remember this can take up to 2 weeks to action).
Biologics and JAK inhibitor treatment - you will need to let the Rheumatology team know by contacting our advice line service so that Rheumatology can restart your prescriptions and notify the Home Care Pharmacy team to restart Deliveries (remember this can take up to 2 weeks to action)
Most of our patients have their blood taken at their GP practice. Sometimes the GP arranges for the blood to be taken at the local hospital. All blood test results should still go back to the GP or you can have these at local blood test by booking an appointment.
You'll find more information how to make an appointment for a blood test here.
In general, we require a full blood count CRP/ ESR (measure of inflammation) , full blood count (FBC), liver function tests, creatinine, and U&Es to monitor medication.
For more information about understanding Blood tests visit
https://
Shared care is the transfer of clinical responsibility from a hospital or specialist service to your GP to continue to supply a medication and the necessary blood monitoring required.
If your GP agrees to take on shared care responsibilities, you are advised to contact your GP surgery to find out how they intend to organise the blood tests and repeat prescriptions for you.