Table 1 Key Clinical Questions used to develop this recommendation
Core item | Key clinical question | Domains |
|---|---|---|
4. Definition | 1. How to describe this patient cohort? | 1.1. Terminology & definition of D2T |
1.2. Challenges in identifying D2T | ||
5. Characteristics | 2. What are the characteristics of D2T and how to assess D2T patients? | 2.1 Patient characteristics |
2.2 Illness characteristics | ||
2.3 Treatment history characteristics | ||
2.4 Assessment of D2T patients (PROMs/Lab/US) | ||
2.5 Comorbidities | ||
2.6 In what aspects is D2T different? | ||
6. Goals | 3. What are the goals of the management of D2T? | 3.1 Strive for optimal symptom control |
3.2 Reduce risks and impact of flare-ups/relapse | ||
3.3 Optimization of HRQoL/functioning’ and return to a ‘meaningful life’ | ||
3.4 Optimize treatment adherence | ||
7. Principles | 4. What are the principles of the management of D2T? | 4.1 Identification of treatment goals based upon ‘shared decision making’ with the patient |
4.2 Implementing measurement-based care | ||
4.3 Enhance engagement and regular monitoring under care of the service | ||
4.4 Supporting self-management strategies | ||
4.5 Set up ‘integrated service pathways’ | ||
4.6 Frequent re-assessment and consideration of treatment direction | ||
8. Clinical approach of tackling D2T in standard practice | 5. How to put goals and principles into practice? | 5.1 Treatment strategy |
5.2 Measuring treatment success |