Stop reasons

When you enter a stop date for a drug, please take care to ensure the correct stop reason is selected. Below are descriptions and examples for the stop reasons currently in use. If you’re unsure of which to use, please select the one that you think would be most appropriate and provide further details in the Stop reason details box. We can then review the stop reason and change it if necessary.

Inefficacy

• A complete stop to a therapy that is not effective
• Increases to the dose or frequency of a drug to tackle a flare or rising PASI

Adverse events

• Any adverse event causing the decision to stop the drug
• Reduction in dose where the patient was having side effects

Inefficacy and adverse events

• Any combination of the above two reasons

Remission

• The disease is in remission
• Should only be used where the treatment is stopped completely due to the patient’s skin being completely clear
• Should not be used for a reduction in dose

Patient non-compliance

• Patient failing to attend clinic
• Drug delay issue related to the patient failing to attend
• Patient not taking the drug as prescribed

Titration

• Standard dosing patterns (both increases and decreases in dose) for Methotrexate, Fumaric Acid Esters, Skilarence and Ciclosporin
• End of treatment cycle for Ciclosporin
• Should only be used for Methotrexate, Fumaric Acid Esters, Skilarence and Ciclosporin – not used for dose changes in any other drug

Financial consideration

• Switching from an originator biologic to a biosimilar due to a change in trust policy
• Switching from Fumaric Acid Esters to Skilarence due to a change in trust policy

Contraindication

• Should be used when the patient stops the drug as other circumstances make the treatment inadvisable
• Examples include stopping for family planning reasons, to have a vaccination, to commence on a different immunosuppressant therapy, or stopping for surgery

Patient choice

• The patient has chosen to end the treatment and no further details are available

Clinical trial

• The patient has stopped a drug they were taking as part of a clinical trial due to the trial ending
• Should not be used when the patient stops a drug to enter onto a clinical trial

Death

• The drug was stopped because the patient passed away
• If the decision is made to stop a drug due to an adverse event that later leads to patient death, this would be classed as Adverse Events instead of Death

Other

• Should only be used when none of the other reasons are applicable
• E.g. dose reduction in non-titrating drug
• E.g. patient going on holiday