Patient-Reported Outcomes and Quality of Life Poster Presentation

P1051 - Real world practice patterns and patient experiences related to off-site therapy infusions in Multiple Sclerosis (ID 1717)

Speakers
  • B. Greenberg
Authors
  • B. Greenberg
  • B. McCartney
  • L. Jarzylo
  • C. Heggen
  • J. Carter
  • T. Sapir
Presentation Number
P1051
Presentation Topic
Patient-Reported Outcomes and Quality of Life

Abstract

Background

With implementation of “site of care” policies in recent years, an increasing number of health plans now require patients with multiple sclerosis (MS) to receive their infused therapies at non-hospital outpatient centers. In a quality improvement (QI) initiative, we examined patients’, neurologists’, and infusions centers’ practices, perceptions, and barriers related to off-site infusion care following this shift.

Objectives

Assess (1) therapy adherence, administration, and adverse event (AE) monitoring at off-site infusion centers; (2) communication and care coordination between MS clinics and infusion centers; (3) provider and patient perceptions of infusion care; (4) barriers to optimal infusion care.

Methods

(1) Reviews of electronic medical records (EMRs) of MS patients (n = 100) in 3 large specialty clinics; and (2) surveys administered to providers from MS clinics [n = 15] and infusion centers [n = 33], and patients [n = 18].

Results

EMR reviews indicated that 53% of patients missed at least some of their infusions at off-site centers. The vast majority of patients (75%) identified scheduling as the greatest barrier to therapy adherence, however, only 50% of MS clinic and 5% of infusion center providers considered scheduling a significant barrier to care. Discordances were also observed on how often infusion-related details are being communicated, including frequently/very frequently sharing whether patients received their infusions as prescribed (33% MS clinics vs 74% infusion centers; p=.008) and a numerical difference in whether patients had infusion-related AEs (40% vs 61%; p=.180). In fact, infusion notes were only documented for 29% of infusions and over half of patients had infusion-related AEs. Providers also differed on their perceptions of the following as significant barriers to care: lack of time to communicate (80% MS clinic vs 10% infusion center; p<.001); ineffective procedures for bidirectional communication (73% vs 3%; p<.001); oversights in regular communication and follow-up (67% vs 17%; p=.001); and insufficient sharing of patient information (74% vs 17%; p=<.001).

Conclusions

Our findings reveal opportunities to optimize MS infusion care, including improved scheduling procedures and patient monitoring. In addition, aligning communication and care coordination practices among providers has the potential to enhance the quality of care for MS patients receiving their infusions off-site.

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