Patient's experience and quality of care when moving to at home natalizumab: a prospective evaluation of multiple sclerosis patients (TYSAD-35)

ABSTRACT

Introduction: The patient's care experience is a crucial factor to consider in order to improve the quality of care and the quality of life in multiple sclerosis (MS). In the context of COVID-19 pandemic, the French health authorities allowed the administration of natalizumab at home by at-home health service. Objective(s) The main objective was to evaluate the quality of care from the point of view of the patients when moving from hospital to at home natalizumab administration. Aim(s) Improve quality of care and quality of life in multiple sclerosis. Method(s) Thirty relapsing remitting MS patients treated with natalizumab since more than 6 months were prospectively recruited to benefit from an at home procedure that was evaluation during 1 year by using the following questionnaires MusiCare, the first specific MS patient's experience, was filled out at baseline, 6 and 12 months ;MusiQol (to assess quality of life), ExPerf (adapted from the PPE15 to assess practice experience) and a satisfaction scale were filled out every months. The primary endpoint was the mean difference of MusiCare scores between Baseline and 12 months. Result(s) From June 2020 to November 2021, 306 infusions were performed at home. Three patients stopped the study (one loss of follow-up, two preferred to move back to hospital's procedure). No worsening of patients experience or quality of life was observed. One dimension of MusiCare was significantly improved at 12 months compared with baseline (91.5 versus 81.8, p=0.0203) relationship with healthcare professionals. The MusiQol global score remained stable (75.5 vs 72.4) but coping and friend's relationship dimensions were significantly improved at M12 versus baseline (respectively p=0.0491 and p=0.0478). Answers to the ExPerf questionnaire show some pain during infusion (21.8%) and some contradictions between health professionals (17.2%). The mean satisfaction about the care was 9.1/10. MS activity remained low. There was no serious adverse event. Conclusion(s) Positive patient's experience of at home natalizumab administration gives an important opportunity to improve patient's quality of care.