Research by Dr Rachel Dorsey-Campbell, winner of MS MasterClass 3 intermodule project award 2018

All of our attendees carry out a piece of research in an area of MS clinical practice or treatment that interests them.

This project won the MS Academy MasterClass Project Award for 2018, and this snapshot gives you a quick idea of what they found and why. If you want to learn more, just click through to the full research report, or follow the links within the snapshot.

If you would like to contact the alumni who did the research, drop us a line and we’ll put you in touch where possible.

 

Aim

To investigate how introducing pharmacy-led prescribing of natalizumab would impact the quality of monitoring and therefore patient-safety.

Headlines

  • Regular monitoring of MS patients on natalizumab through MRI imaging and blood tests puts a significant burden on specialist centres
  • Patients on natalizumab at Imperial College Healthcare Trust (ICHT) MS centre were evaluated before (2016 data) and after (2018 data) introducing a pharmacy-led prescribing and monitoring service.
  • The researcher looked at 331 patients treated with natalizumab to find out:
    • how often they had a review with their consultant
    • their EDSS scores,
    • their JC virus (JCV) status measurements
    • the timeliness of their MRI assessments

Key findings

  • A pharmacist reviewed 839 prescription charts from December 2016 – April 2018
    • Treatment duration ranged from one month to nine years with an average of four and a half years, and 53 doses.
    • EDSS score ranged from 1 to 7.5 with an average of 3.9
    • From a subgroup of 299 patients (2017 records) 40% had a negative JCV status, 60% a positive one. 28% of these had low titre (≤ 1.5) and 32% had high (> 1.5).
  • After the pharmacy-led prescribing and monitoring service was introduced (Dec 2016):
    • More patients had a recorded EDSS score (74% before to 86% after)
    • JCV status had been assessed in 100% of cases (98% before).
    • MRI scans were carried out in a much more timely manner with 16% overdue before, and just 5% overdue after.
    • The subgroup with a high JCV titre went to just 1.8% with overdue MRIs (from 7.6%) with none overdue by more than 3 months: a significant improvement.

Core recommendations

  • A pharmacy-led prescribing and monitoring service:
    • is possible to set up,
    • frees up time for the MS clinical team
    • greatly helps in compliance with natalizumab monitoring requirements, which overall improves patients safety.

 

Take action

  • Read the full presentation.
  • Contact the researcher to discuss their work (please put the name of the Snapshot as your title in our contact form)
  • Learn more about the issues raised in this report. Click the scattered links to access further information.

 

Click on the image for a full size pdf