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- Page navigation anchor for Saving the planet, patients (and physicians) with reduced blood monitoring frequencySaving the planet, patients (and physicians) with reduced blood monitoring frequency
We are in the middle of a climate crisis, with a long way to go towards our target of reaching carbon net zero in the NHS. With over 630 million haematology and biochemistry tests ordered annually in NHS England1, this equates to more than 60,000 metric tonnes of CO2 per year2. More than half of requests are for patients with chronic disease, and, as demonstrated by Fraser et al.3, large proportions of patients stable on disease modifying antirheumatic drugs (DMARDs) are likely to have persistently normal blood results. It is thus vital for the environment that we rethink our DMARD monitoring strategy.
These findings are further supported by Nakafero et al.4, who found that severely abnormal blood results in patients established on methotrexate are uncommon. In our own cohort of patients stable on Methotrexate in North Devon, we found that reduced monitoring frequency did not lead to more abnormal results and that severely abnormal results were rare, only occurring in the context of concurrent illness5. Furthermore, prepandemic local practices were testing this group of patients monthly, rather than three monthly as per British Society of Rheumatology (BSR) guidelines. Reducing frequency to meet these guidelines would have significant carbon savings. Additionally, we must consider the impact of frequent monitoring on our patients, who are often older, less mobile, and may have a long journey to their GP.
Reduced D...
Show MoreCompeting Interests: None declared.