THUR 199 MS DMT monitoring according to abn guidelines & product specification

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Abstract

Aim

Retrospective audit monitoring Multiple Sclerosis (MS) patients on Disease Modifying Therapies (DMT’s) according to Association of British Neurologists (ABN) guidelines (2015) and product specifications. This requires blood tests prior and during treatment and reviews by MS professionals.

Methods

MS nurse database identified patients, records were reviewed and data extracted including bloods, JC virus (JCV) testing, imaging, specialist tests and counselling. Analysis was presented to the MS team. Protocols and referral pathways were designed, and new patients were re-audited.

Results

The first cycle comprised of 280 patients, representing 325 individual DMT regimens. Prior to commencing treatments 90.7% blood tests, 58% imaging, and 60% JCV testing was completed on average. At 12 months, this decreased to 88.7% bloods, 30% imaging, and 25% JCV testing. Electronic records revealed that counselling documentation was sometimes incomplete. The second cycle analysed 55 patients showing improvement in Progressive multifocal leukoencephalopathy counselling and annual imaging.

Conclusion

Monitoring of bloods is done at a high standard, imaging and JCV testing less frequently meet monitoring guidelines. Factors influencing this include rural locations, variation in practice, and changing guidelines. Further work will include yearly follow-up, documentation of stopping criteria and regular review of monitoring guidelines. Patient involvement should be considered.

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