Introducing high dose steroid therapy for MS relapses into the community

Abstract

South Staffordshire primary care trust (PCT) has seen a rise in the number of specialist nurses working in the community and the development of a wide range of intermediate care services. The Community Intervention Team (CIT) has offered the patients of East Staffordshire the choice to receive intravenous antibiotics, blood transfusions (Pott, 2009), and other intravenous therapies in their own homes rather than as hospital in-patients, for over five years. The local multiple sclerosis clinical nurse specialist (MS CNS) has worked closely with CIT when any MS patients have needed extra support at home to manage a crisis and this led the authors to consider how they could work together to prevent some of these crises occurring. In this article they authors outline how they used an award from the Queen's Nursing Institute (QNI) to help establish a community-based service to offer patients the option of receiving high-dose steroid therapy at home for treatment of a relapse, within the resources already available in the PCT.

Impact of Home Care Services on Patient and Economic Outcomes: A Targeted Review

“…- Multiple sclerosis (n = 7; 10.9%), 8,21,49-57 5 (71.4%) home care initiatives were aimed at the home administration and monitoring of multiple sclerosis therapies. 8,21,51-54…”

“…Of the 31 home-based care services for which studies were assessing the impact of the initiatives, 9 (29.0%) focused on the effects of home care services on medication adherence and persistence. 18,26,51-53,59,60,63,67,69,70 Most were aimed at addressing the impact of PSPs on adherence to and persistence with a specific medication.…”

“…Of the 31 home-based care services for which studies were assessing the impact of the initiatives, 9 (29.0%) focused on the effects of home care services on medication adherence and persistence. 18,26,[51][52][53]59,60,63,67,69,70 Most were aimed at addressing the impact of PSPs on adherence to and persistence with a specific medication. Six (66.7%) studies showed significant improvements associated with the intervention on the adherence and/or persistence rates for medication for diabetes mellitus, 69,70 IBD, 59 and psoriasis, psoriatic arthritis, and rheumatic arthritis.…”

“…18,60,63 For multiple sclerosis, 3 (33.3%) studies reported improved adherence to a medication through the use of a self-injector device, but further studies are needed to corroborate the findings. [51][52][53] Patient-reported outcomes. HRQoL.…”