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J Infus Nurs. 2019 Nov/Dec;42(6):289-296. doi: 10.1097/NAN.0000000000000343.

Developing a Model of Care for Home Infusions of Natalizumab for People With Multiple Sclerosis.

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Adelaide Nursing School, University of Adelaide, Adelaide, South Australia, Australia (Drs Schultz and Cusack, Ms Juaton); Post Op Care at Home (Pty Ltd), McLaren Vale, South Australia, Australia (Ms Thomas); Royal Adelaide Hospital, Adelaide, South Australia, Australia (Mr Georgiou, Mr Webb, Ms Simon, and Dr Ravindran); Biogen Inc, Tokyo, Japan (Ms Naidoo); College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia (Dr Karnon). Timothy J. Schultz, PhD, is senior research fellow and postgraduate coordinator in Adelaide Nursing School. He is an interdisciplinary researcher who focuses on the role of nursing in health care delivery. His main areas of research are systematic reviews, health services, patient safety, and the implementation of evidence into practice. Anne Thomas, BSc, RN, is an experienced registered nurse and director of Post-Op Care At Home (Pty Ltd), which was subcontracted to deliver home infusions. She has extensive experience with the pharmaceutical industry, including delivering home infusions with Baxter Healthcare and companies throughout Australia. Paul Georgiou, MNsg(AcuteCare), RN, is the nurse unit manager at the Medical Day Treatment Unit, Royal Adelaide Hospital. This unit manages people with life-long chronic diseases as a referral service delivery by skilled nurses. Mr Georgiou is also a member of the Royal Australian Army Nursing Corps, with experience in operational and nonoperational roles. Lynette Cusack, PhD, MHA, RN, is an associate professor in the Adelaide Nursing School. Her research focus is on the contemporary role of the nurse in a range of different contexts, redefining models of practice, including impact on the health care system, interdisciplinary team, and patients' experience. Mahasen Juaton, MNsg, RN, is a master of clinical science (research) candidate at the Adelaide Nursing School. Lorraine Simon, MNsg, RN, is the assistant nurse unit manager at the Medical Day Treatment Unit at Royal Adelaide Hospital. Kerisha Naidoo, MPharm, MBA, is an employee of Biogen Inc, a multinational biotechnology company specializing in the discovery, development, and delivery of therapies for neurological diseases. She is the head of the medical excellence and operation team in Japan, leading data generation, medical operations, field medical excellence, and patient services functions. Kevin Webb, BNurs, RN, is a neurology nurse consultant at Royal Adelaide Hospital and the Queen Elizabeth Hospital. Jonathan Karnon, PhD, MSc, is a health economist at Flinders University. His main area of research is the use of economic evaluation to inform health service decision-making. Dr Karnon has developed and applied methods for the economic evaluations of health care technologies and services in Australia and the United Kingdom. Janakan Ravindran, MBBS, is a consultant neurologist at the Royal Adelaide and Lyell McEwin hospitals. He is currently the clinical lead for neuroimmunology at the Royal Adelaide Hospital and has particular subspecialty interests in multiple sclerosis and other neuroimmunological conditions, as well as peripheral neuromuscular disorders.


Natalizumab is an effective treatment for multiple sclerosis that requires 4-weekly infusions that are usually provided in hospital outpatient clinics. In this study, a model of care (MOC), an overarching design for the provision of a health care service, was developed to permit home infusions of natalizumab. The proposed new MOC comprised 9 dimensions, in addition to the central concept of patient-centered care at home. The new MOC is responsive to patient needs and prioritizes the nurse-patient therapeutic relationship. It provides practical examples of patient-centered care to guide clinical practice for this patient population in the home setting.

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