Care Pathway for TNF α-Blockers for Patients with Rheumatoid Arthritis at the Royal National Hospital for Rheumatic Diseases

Tumour necrosis factor (TNF) blockers are effective in the treatment of rheumatoid arthritis. These drugs are expensive, however, and there is uncertainty over their long-term safety. The National Institute for Clinical Excellence has issued guidance over the use of these drugs in rheumatoid arthritis. The Royal National Hospital for Rheumatic Diseases developed an integrated care pathway following the patient's journey from referral to the TNF services until the administration and continued monitoring of their response in accordance with NICE Guidance, taking into account local issues. This paper reviews the development and implementation of this pathway.