2023 Oral ALS Therapy Clinical Abstract

Role of the Pharmacist in Monitoring Oral Edaravone for Amyotrophic Lateral Sclerosis

Authors: Christine Miller, PharmD; Barbara Prosser, RPH; Timothy Walton, MHS, CCRP – Soleo Health

Objective

To consider the number and types of clinical interventions performed with patients receiving oral edaravone from this complex specialty pharmacy organization.

Background

Oral edaravone is indicated in the treatment of amyotrophic lateral sclerosis (ALS). The oral treatment was approved in May 2022 and has allowed patients more freedom from intravenous dosing constraints and decreased need for nursing support. Specialty pharmacies routinely dispense oral medications that are administered by the patient or a caregiver. Although the patient or caregiver is independent in medication administration, the patient should still be closely monitored by the dispensing pharmacy. The route of administration may change as the patient’s disease progresses. The transition from oral intake to enteral administration can be anticipated and the patient’s needs addressed for a smooth transition. Routine contact with the patient to identify potential problems can provide early intervention opportunities and cultivate patient adherence.

Design/Methods

Educational materials are reviewed with the patient prior to therapy initiation. Using a therapy-specific assessment database, SoleMetrics®, patients are contacted telephonically prior to every dosing cycle. Monitoring parameters include:

Continuing education based on assessment findings ensures ongoing therapy success. Activities performed outside of the customary dispensing and administration processes that could potentially impact the patient’s course of therapy are documented as clinical interventions.

Results

• Monitoring effectiveness and real-world usage are evaluated based on the number of successful interventions and the reason for discontinuing therapy.
• From 05/16/2022-10/04/2022, a total of 227 patients received oral edaravone from this complex specialty pharmacy organization.
• 193 interventions were performed for 123 patients.
• One-third of the documented events contained multiple interventions during the same patient contact.