The Ocrelizumab Pharmacy Service at the Leeds Teaching Hospitals NHS Trust (LTHT): Improving the Patient Experience
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To review the West Yorkshire MS Treatment Programme’s (WYMST) ocrelizumab pharmacy service in order to:
- Understand the patient experience on the day unit
- Ensure timely availability of infusions
- Establish a safe and appropriate pace to compound ocrelizumab infusions
- Ensure safe and effective ocrelizumab prescribing
- Ocrevus (ocrelizumab) was approved for relapsing-remitting MS (RRMS) in 2018, and for early primary progressive MS (PPMS) in 2019
- At WYMSTP, patients eligible for ocrelizumab are consented by MS nurses and receive treatment on the LTHT day unit along with patients with other neurological conditions. Independent prescribing pharmacists (IPP) undertake prescribing, using paper charts, by liaising with LTHT aseptic services
- The approval of ocrelizumab means a potential increase in prescribing, day case admissions, and aseptics involvement in the manufacture of monoclonal antibodies (MABs)
Between 1 November 2018 and 31st December 2019:
- 92 doses of ocrelizumab were administered
- 63 RRMS patients received ocrelizumab infusions
- IPPs spent around 10 mins prescribing the infusion on the paper chart
- The average time it took for the infusion to arrive in the day unit was 155 mins (range: 63 minutes to 289 minutes)
- A patient survey found that the overall experience was good, but the wait time was a bone of contention for many
- A staff survey found most doses were compounded by nurses on their own units, rather than the day unit
- Pilot pre-making ocrelizumab in aseptics within 24 hours of the patient’s appointment and ascertain if the improved patient experience outweighed the potential financial risk
- Evaluate how the ChemoCare electric prescribing pilot, currently being undertaken at LTHT, could benefit other day case treatments, including ocrelizumab
- Collaborate with the aseptics unit to establish an electronic alternative to paper charts for prescribing ocrelizumab
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