, new data suggest.
Dr. Jenelle Montgomery
“As DMT management and treatment options for MS symptoms become more complex, clinical pharmacists can be utilized for medication education and management,” Jenelle Hall Montgomery, PharmD, a clinical pharmacist practitioner at the Multiple Sclerosis and Neuroimmunology Division, department of neurology, Duke University Hospital, Durham, N.C., told delegates attending the 2021 Annual Meeting of the Consortium of Multiple Sclerosis Centers (CMSC).
Since 2018, more than half a dozen DMTs have been approved for MS by the U.S. Food and Drug Administration. However, there is currently no established DMT selection algorithm, and because of this, there is a need for specialty pharmacists, she added.
“DMT approvals by the FDA have outpaced MS guideline recommendations. This can be overwhelming for patients, especially now that they have so many options to choose from,” she said.
Key services provided by specialty pharmacists include coordinating pretreatment requirements, as well as help with dosing, side effects, safety monitoring, and treatment adherence. In addition, pharmacists help with switching therapies, dispensing, and cost and authorization problems.
In reporting on improvements associated with specialty pharmacists, researchers from prominent MS centers around the country described specific outcomes.
Aids early intervention
A report on the Kaiser Permanente Washington (KPWA) MS Pharmacy Program detailed significant reductions in the time to address patients’ needs through the use of specialty pharmacists. In an assessment of 391 referrals to the program from 2019 to 2020, the average total time spent per patient per year dropped from 145 minutes in 2019 to 109 minutes in 2020.
Services included assessment of medication adherence, adverse drug reaction consultation, lab monitoring, patient counseling on initiation of a DMT, shared decision making, and follow-up visits.
“The KPWA MS Pharmacy Program plays an integral role in the care of patients with MS. The MS clinical pharmacists ensure patients are well informed about their DMT options and are fully educated about selected treatment,” the investigators noted.
A report on an outpatient MS clinic at Emory Healthcare, Atlanta, described how use of specialty pharmacist services resulted in a 49% reduction in time to treatment initiation with fingolimod. The time decreased from 83.9 days to 42.9 days following the introduction of specialty pharmacist services.
“Integration of a clinical pharmacy specialist in the therapeutic management of MS patients is crucial to early intervention with disease-modifying therapy,” the investigators noted.
A report on the specialty pharmacy services provided at Johns Hopkins MS Precision Medicine Center of Excellence, Baltimore, described an evaluation of 708 assessments between July 2019 and June 2020. Results showed that the vast majority (98%) of patients reported no missed days from work or school due to MS-related symptoms and that 99.3% reported no hospitalizations due to MS relapses, which are both key measures of MS treatment adherence.