Developing a Model of Care for Home Infusions of Natalizumab for People With Multiple Sclerosis.
Timothy J Schultz, Anne Thomas, Paul Georgiou and 7 others
PMID 31693562WHAT IT FOUND
A team built a detailed home-infusion model for natalizumab in multiple sclerosis, covering nurse training, drug transport, monitoring, adverse-event response and patient-centered scheduling.
It describes how care could be organized, not that it is safe or effective.
Key findings
01The home-infusion model was built from literature, standards and policies, and team consensus.
02The model was intended to be tested in a later exploratory trial, not shown to work in this paper.
03Patients were eligible only if they had had at least 6 previous natalizumab infusions, to lower the chance of a hypersensitivity reaction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This phase reported model development, not patient outcomes, so it cannot show the model is safe, effective, feasible or acceptable. The literature search found 35 studies, but they were not critically appraised. The model was built around one medication, natalizumab, and one organization's day-infusion clinic protocols. Home nursing care and consumables were funded by the drug manufacturer, which may shape priorities.
Declared interests
Home nursing care and consumables were funded by Biogen Australia and New Zealand, the manufacturer of natalizumab. The project was a collaboration that included a pharmaceutical company.
The easy way to misread this
Do not read this as evidence that home natalizumab infusions are safe or effective. The paper only describes a model built from literature and consensus, and says it was intended to be tested in a later exploratory trial.