If your arthritis is not well controlled on conventional therapy, your treatment may be escalated to either a biologic disease modifying anti-rheumatic drug (bDMARD) or targeted synthetic disease modifying anti-rheumatic drugs (tsDMARD). If your Consultant thinks this is the most appropriate treatment option for you, you will have an appointment with a specialist nurse or specialist pharmacist to discuss starting treatment.
These therapies are either administered via an infusion (‘drip’) in the hospital’s Medical Day Care Unit or supplied by a home delivery company and injected at home (and some of the newer therapies can be taken in tablet form). The specialist nurse or specialist pharmacist will discuss different treatment options with you, including the risks and potential benefits. Once you have commenced treatment, you will be followed up under the new bDMARD | tsDMARD monitoring pathway.
Some of the follow up appointments will be in a special type of remote consultation, called the Remote Therapy Clinic (RTC). These will either be routine RTC appointments where we will send you an appointment letter inviting you to the consultation or they might be ad hoc RTC appointments where we will review your clinical information and might call you out of the blue (for example if we have been informed that you are running out of medication supplies). If we send you an invite letter to a routine RTC appointment (see example letter below) it is important that you carry out the required steps before your appointment. This includes having up to date blood tests at your GP surgery and completing your disease activity assessment scores on the disease activity tracking application if you have a smart phone.