Developing better systems to manage the medical complexities of long-term corticosteroid therapy in a rheumatology clinic
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All Authors
Shah, Shirley
Rao, Sinchna
Mackie, Sarah
LTHT Author
Mackie, Sarah
LTHT Department
Rheumatology
Non Medic
Publication Date
2025-07-10
Item Type
Conference Abstract
Language
en
Subject
Subject Headings
Abstract
Background: Musculoskeletal conditions such as polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) frequently require prolonged corticosteroid therapy, which carries risks including osteoporosis, glaucoma, and dental complications1-3. Current NHS systems lack a centralised method for tracking these patients, often resulting in gaps in monitoring and care.
Aims: This project aims to evaluate the feasibility and acceptability of a novel digital clinical registry designed to monitor rheumatology patients on long-term steroids. It also seeks to identify potential gaps in care provision and explore demographic factors, such as age, sex, and ethnicity that may influence patient management.
Methods: An observational feasibility study will be conducted over one year within rheumatology clinics at Leeds Teaching Hospitals. Approximately 20–30 patients undergoing long-term
corticosteroid treatment will be recruited. During routine consultations, clinicians will use a checklist based approach integrated into a no-code platform developed on a platform called ‘Ledidi’ to collect data on steroid management, screening for side effects (e.g., bone health, eye and dental examinations), and patient demographics. Data will be securely stored on Ledidi and linked to patient records via NHS numbers under an established data sharing agreement.
Results: The study seeks to identify potential care gaps such as delays in recommended optician and dental reviews. This will help inform future initiatives, ensuring patients on long-term steroids are educated about the side effects of their treatment and how to mitigate for this. The study will also assess both patient and clinician satisfaction with the registry process.
Conclusion: This pilot study could pave the way for a scalable digital tool to enhance monitoring and management of long-term corticosteroid use in rheumatology patients. Successful implementation may lead to improved patient outcomes and more efficient NHS practices in caring for this patient group.
References:
1. Wilson JC, Sarsour K, Collinson N, Tuckwell K, Musselman D, Klearman M, et al. Serious adverse
effects associated with glucocorticoid therapy in patients with giant cell arteritis (GCA): A nested
case–control analysis. Semin Arthritis Rheum. 2017 Jun;46(6):819–27.
2. Buttgereit F. Views on glucocorticoid therapy in rheumatology: the age of convergence. Nat Rev
Rheumatol. 2020 Apr 19;16(4):239–46.
3. Proven A, Gabriel SE, Orces C, O’Fallon WM, Hunder GG. Glucocorticoid therapy in giant cell
arteritis: Duration and adverse outcomes. Arthritis Care Res (Hoboken). 2003 Oct 15;49(5):703–8.