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

Oral edaravone is indicated in the treatment of amyotrophic lateral sclerosis. The oral treatment was approved in May 2022 and has allowed patients more freedom from intravenous dosing constraints and decreased the need for nursing support. Specialty pharmacies routinely dispense oral medications that are administered by the patient/caregiver. Although the patient/caregiver is independent in medication administration, the patient should still be closely monitored by the dispensing pharmacy. Routine contact with the patient to identify potential problems can provide early intervention opportunities and cultivate patient adherence.

Educational materials are reviewed with the patient prior to therapy initiation. Using a therapy-specific assessment database, SoleMetrics^®, patients are contacted telephonically prior to each dosing cycle. Monitoring parameters include quality of life measures, side effects, adherence, dosing time, and storage. Events potentially impacting the patient’s course of therapy are documented as clinical interventions.  

From 05/16/2022-10/04/2022, 227 patients have received oral edaravone from this national specialty pharmacy. 193 interventions were performed for 123 patients. One-third of the documented events contained multiple interventions during the same patient contact. The main intervention reasons included patient counseling (52%), adverse reactions (21%), and drug adherence (20%). Additional interventions (≤2%) were related to drug interaction investigations, laboratory evaluation, patient status change, drug wastage, patient fall, and financial considerations. Additional patient education was provided during 81% of documented interventions. Dose(s) were held for 5% of patients and therapy was discontinued for 4% of patients. 

Closely following independent patients taking oral medications at home helps the pharmacists to promptly identify barriers to care and provide interventions to optimize therapy. Allowing patients to successfully remain on oral therapy gives the patient and family additional freedom in a progressively limiting diagnosis.