P07.12 | A single centre experience of adult outpatient monitoring of ITP: Patient burden and future improvements

Published Date: 23rd March 2026

Publication Authors: Saleem. S, Nicholson. T

Immune thrombocytopenia (ITP) is a rare autoimmunedisorder characterised by low platelet count. It is commonlymanaged in the outpatient setting.A recent audit of attendances and full blood count (FBC)monitoring of patients with ITP in a district general hos-pital in the North-West UK suggests that blood tests werebeing performed too frequently. This has an impact on pa-tients, staff and the overall Haematology Day-Ward service/provision.Significant time and effort are required by patients to attendthe day unit frequently; potentially meaning time off work,having to organise transport to and from the day unit, park-ing charges etc. particularly for those more elderly patients.There is also additional pressure on staff and day unit avail-ability in terms of increased numbers of patients frequentlyattending. It is well accepted that excess FBC monitoringcan potentially lead to decisions to dose changes of medi-cation before the patient has stabilised on the current dose,leading to unpredictable swings in platelet count, particu-larly for those patients on thrombopoietin receptor agonists(TPO-RAs).Retrospective data on patients with ITP attending theHaematology Day Ward were reviewed for a 6-month periodbetween January 2025 and June 2025. In total, there were 21patients with ITP included, with a median age of 72 years(range: 24–88 years) and 60% were female. There were 217attendances during this time, with a median of 10 visits perpatient (range: 5–16 visits, over a 6-month period).The most common treatment prescribed was Avatrombopag(43%), followed by corticosteroids (14%). Other treatmentsincluded Eltrombopag, Romiplostim, Azathioprine andMycophenolate Mofetil. Only 5% of outpatient blood testsperformed led to a dose adjustment or change in manage-ment, with 62% of patients (n = 13) having no change in theirmanagement despite regular monitoring.There were no thrombotic episodes reported during thistime. Three patients reported haemorrhagic symptoms(2× petechial rash, 1× bruising). Importantly, it was notedthat when a patient with ITP had a platelet count that haddropped to single figures, they often became sympto-matic with mucosal bleeding or petechiae, and thereforeself-presented or alerted the Haematology Team outside ofS296 |ABSTRACTscheduled appointments, emphasising the importance ofsafety netting advice provided.In response to these findings, a guidance document has beendeveloped on frequency of outpatient monitoring/dose ad-justments of TPO-RAs and immunosuppressive medicationfor adult patients with Immune Thrombocytopenia to try tosafely reduce the frequency of day-ward attendances.

Shaw, R.; Saleem, S.; Nicholson, T. (2026). A single centre experience of adult outpatient monitoring of ITP: Patient burden and future improvements. British Journal of Haematology. 208(S1), p.S295. [Online]. Available at: https://onlinelibrary.wiley.com/toc/13652141/2026/208/S1 [Accessed 10 September 2026].