Quality standard
Quality statement 6: Monitoring systemic therapy
Quality statement 6: Monitoring systemic therapy
Quality statement
People with psoriasis receiving systemic therapy are monitored in accordance with locally agreed protocols.
Rationale
Systemic therapy for psoriasis poses a risk of adverse events, for which careful monitoring is needed. It is essential that monitoring is in accordance with national drug guidelines to minimise this risk. Where shared care arrangements are in place, it is important that the roles and responsibilities of healthcare professionals involved in monitoring people with psoriasis receiving systemic therapy are clearly outlined in a formalised local agreement.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
What the quality statement means for different audiences
Service providers ensure that systems are in place for people with psoriasis receiving systemic therapy to be monitored in accordance with locally agreed protocols.
Healthcare practitioners ensure that people with psoriasis receiving systemic therapy are monitored in accordance with locally agreed protocols.
Commissioners ensure that they commission services for people with psoriasis receiving systemic therapy to be monitored in accordance with locally agreed protocols.
People with psoriasis receiving drug treatment known as 'systemic therapy' are monitored according to a locally agreed procedure.
Source guidance
Psoriasis: assessment and management. NICE guideline CG153 (2012, updated 2017), recommendations 1.5.1.1 and 1.5.1.5
Definitions of terms used in this quality statement
Systemic therapy
Systemic therapy includes biological and non-biological therapies.
Responsibility for use of systemic therapy should be in specialist consultant-led settings only. Certain aspects of supervision and monitoring may be delegated to other healthcare professionals and completed in non-specialist settings. In such cases, the arrangements should be formalised.
Monitoring
Monitoring should be in accordance with locally agreed protocols that incorporate national accredited drug guidelines and policy.
Relevant national accredited drug guidelines include:
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Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people (2017) NICE technology appraisal guidance 455
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Ixekizumab for treating moderate to severe plaque psoriasis (2017) NICE technology appraisal guidance 442
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Secukinumab for treating moderate to severe plaque psoriasis (2015) NICE technology appraisal guidance 350
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Psoriasis: assessment and management (2012, updated 2017) NICE guideline CG153
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Ustekinumab for the treatment of adults with moderate to severe psoriasis (2009, updated 2017) NICE technology appraisal guidance 180
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Adalimumab for the treatment of psoriasis (2008) NICE technology appraisal guidance 146
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Infliximab for the treatment of psoriasis (2008) NICE technology appraisal guidance 134
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Etanercept and efalizumab for the treatment of adults with psoriasis (2006) NICE technology appraisal guidance 103
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Guidelines for biologic interventions for psoriasis (2009) British Association of Dermatologists
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Guidelines on the efficacy and use of acitretin in dermatology (2010) British Association of Dermatologists