Compliance with NICE guidance on the use of anti-TNFα agents in ankylosing spondylitis: an East and West Midlands regional audit

• Published in: Clinical medicine (London, England) England), 2012-08, Vol.12 (4), p.324-327
• Main Authors: Rees, Frances, Peffers, Gillian, Bell, Carolyn, Obrenovic, Karen, Sandhu, Ravinder, Packham, Jonathan, Erb, Nicola
• Format: Article
• Language: English
• Subjects: ankylosing spondylitis; anti-TNFα; audit; Biological and medical sciences; Clinical Practice; Diseases of the osteoarticular system; Diseases of the spine; General aspects; Inflammatory joint diseases; Medical sciences; NICE
• ISSN: 1470-2118; 1473-4893
• DOI: 10.7861/clinmedicine.12-4-324

Here we report on an audit performed to examine compliance with National Institute for Health and Clinical Excellence (NICE) guidelines for the use of anti-tumour necrosis factor alpha (anti-TNFα) in treating patients with ankylosing spondylitis (AS). Data from 17 rheumatology centres across the Midlands were collected prospectively from patients with AS attending outpatient clinics and retrospectively in patients receiving anti-TNFα but not attending outpatient clinics during the audit. In total, 80% of the 416 patients for whom data were collected were male. Of the 238 patients recruited prospectively, 41% were receiving anti-TNFα. Reviewing all patients on anti-TNFα (N=275), pre-treatment assessments 12 weeks apart were documented in 55% of patients. After anti-TNFα treatment had started, regular 12-weekly assessments occurred in 46% of patients. Therefore, compliance with NICE guidance was found to vary among centres. Based on our audit, clinical capacity, and clinical or patient choice might be influencing the suboptimal adherence seen in assessment timing suggested by NICE guidelines relating to the use of anti-TNFα in treating patients with AS.