| Autor: |
D Allen, L Elsey, D Menzies, LJ Holmes, Robert Niven, Binita Kane, J Corless, Aashish Vyas, J Blakey, S Scott, N Seghal, Stephen J. Fowler, H Burhan, R O’Driscoll, S Khurana |
| Rok vydání: |
2018 |
| Předmět: |
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| Zdroj: |
Asthma: which biologic when?. |
| DOI: |
10.1136/thorax-2018-212555.88 |
| Popis: |
Background The 2013 NHS England service specifications for severe asthma aimed to develop a limited number of high volume specialist hub centres. These centres would have a multi-disciplinary team (MDT) working to improve patient outcomes and reduce healthcare costs. In the North West we have developed a networked approach to specialised severe asthma services; the first Operation Delivery Network (ODN) for a chronic disease. Representatives from 11 NHS Trusts and a central hub undertake a monthly virtual MDT meeting with physicians, nurses, pharmacists, physiotherapists, clinical psychologists, speech and language therapists, and radiologists represented. All patients being considered for specialised treatments undergo MDT discussion for consensus approval of treatment. Aim To summarise the experience and case-mix encountered during the first 4 years of operation of our regional virtual severe asthma MDT. Methods We reviewed all cases discussed at the MDT between January 2015 and June 2018. Proformas are submitted via nhs.net accounts and data entered into a central database by MDT coordinator. All biologic proformas are pre-assessed by the ODN Pharmacist and Specialist nurse to ensure compliance with the NICE guidelines. Results During this period 41 meetings were held, with 933 cases discussed. Omalizumab was approved in 78% of cases submitted, BT in 39%, mepolizumab in 84% and reslizumab in 94%. The most common reasons for non-approval of omalizumab were insufficient steroid requirement, poor adherence and lack of allergy to perennial allergen. The most common reasons for non-approval to mepolizumab and reslizumab were poor adherence and lack of evidence of raised eosinophil levels within the stated 12 month period. The potential 5 year cost saving of high cost therapies not approved at the Central hub is estimated to be £7.5 million. Conclusion A multi-site virtual severe asthma MDT meeting facilitates expert care across a wide geographical area, ensures governance in the use of novel and expensive therapies, strengthens collaboration and aims to improve patient care. Reference Ryan D, et al. The UK’s largest severe asthma multidisciplinary team meeting; experience from the first 18 months. ThoraxDec 2016:71(3);A5. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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