DX23
The Importance of the Role of a Patient Safety Coordinator in a Comprehensive Multiple Sclerosis Center.
Traditional disease modifying therapies (DMT) for multiple sclerosis (MS) were first introduced in the 1990s, these drugs remained the mainstay in MS therapy for many years until the introduction of natalizumab in 2005. Since then, a host of newer DMTs have emerged with novel therapeutic approaches and relatively higher efficacy than traditional agents. This efficacious advantage has come at the cost of significant risks and complications associated with highly effective therapies (HETs). Serious infectious and non-infectious risks have been associated with these HETs and this has necessitated the need for creating and implementing clearly outlined standard operating procedures (SOP) for the prevention, early detection and management of complications. The role of a patient safety coordinator (PSC) working alongside clinical providers has emerged as an efficient way to implement SOPs, mitigating the risks associated with these HET.
Objectives:
To demonstrate the benefits of including the role of a patient safety coordinator and clearly outlined standard operating procedure while using highly effective therapies in a comprehensive MS center.
Methods:
The University of Florida MS comprehensive MS center created SOPs for HETs and newer generation DMTs including natalizumab, alemtuzumab, ocrelizumab, rituximab, fingolimod, dimethyl fumarate and teriflunimide. These SOPs contained a clear outline for pre-treatment/baseline assessment, drug administration monitoring, routine follow up assessment, adverse effects and risk assessment and a clear plan on how to manage detected complications. A PSC was assigned the role of ensuring that these SOPs were implemented on all patients taking HET.
Results:
We reviewed records of 70 patients who were on or starting HET. We analyzed compliance with standard pre-treatment assessment, routine assessment and adverse event monitoring prior to and after the intervention i.e. establishment of a PSC role and implementation of SOPs. Prior to the intervention, only 14.3% had received standard adequate assessment and monitoring recommended for HET. Post intervention, compliance to standard recommended monitoring improved to 84.3%. Most incidences of non-compliance were due to failure to obtain adequate pre-treatment work up prior to starting HET.
Conclusions:
With the addition of more effective therapies available for the management of MS, the role of a PSC in implementing SOPs is essential in mitigating risks associated with HET.