The Immunology Home Therapy Service at University Hospitals Plymouth has not only benefitted patients in a number of ways for over 20 years, but it is now also helping to combat an international shortage of antibody treatments. The service, run by the Immunology Specialist Nursing team at the Trust, is seeing greater numbers from Devon and Cornwall than ever before, and now includes other specialties such as haematology and neurology.
“There’s currently a global shortage of immunoglobulins (more commonly known as antibodies) as a result of the pandemic and subsequent reduction of donated plasma,” explains Natalie Leslie, Immunology Specialist Nurse. “Our patients with immune deficiencies and some auto-immune diseases greatly rely on receiving immunoglobulins, so this has been a really challenging time for them. Not only would they be at greater risk of negative outcomes if they were to catch Covid-19, so are therefore still having to shield themselves, but there’s now a reduced availability of treatments that prevent their risk of life-limiting conditions.”
However, thanks to the efforts of Natalie and her colleagues Christine Symons and Alex Nica, as well as their admin support, patients from across Devon and Cornwall can now be referred to a training service for home therapy, being offered locally at the Trust. Utilising this service, patients who previously received intravenous treatment for their immunity diseases are now being offered the opportunity to treat themselves from the comfort of their own home, using a much less invasive and time-consuming approach. Not only that, but by administering the antibodies using this alternative method, it is proving that doses can gradually be reduced, therefore helping to address the global shortage at a local level.
“The team have really gone over and above for the benefit of our patients,” explains Dr Claire Bethune, Consultant Immunologist. “Redeployed to the Covid-19 wards at the start of the pandemic, they still continued to pursue what is best for their patients and attempt to address the global shortage of immunoglobulin at the same time. Thanks to their establishment of this training service, patients are now being referred to us from all over the region and there are so many benefits to them having the treatments at home.”
With the alternative approach, antibodies are administered subcutaneously, with a small needle being inserted under the skin into fatty tissue. The equipment is portable and patients can administer it themselves, at home or wherever they chose, at a time that is convenient to them. Patients with immune deficiencies therefore no longer need to visit the hospital for their treatment every few weeks, which greatly reduces their infection risks, and the reduction in required day case admissions has important cost-savings for the Trust.
“Home therapy is a much better way for patients to manage their condition,” adds Natalie. “It’s flexible and they can fit their treatment in with their day-to-day life. It’s also a much more gentle approach, protecting and preserving their veins from frequently having needles inserted into them. There’s also the bonus of easing the demand for a precious and very much in demand treatment.”
Julie Woodfin, who has been receiving infusions for the last four years, said: “Immune deficiency is a really horrible thing to have and to have to live with, but the infusion of immunoglobulins creates a kind of firewall for the immune system, to protect us and make us more able to cope with infections. So the global shortage of antibodies is of course a real worry.
“Having the treatment at home was a bit daunting at first, but once I got into the swing of it, it quickly became the norm. It’s much more flexible – it doesn’t take long and I can do it whatever day or time of the week that suits me best. Everything is provided that you need and Natalie’s just at the end of the phone if you have any questions.”
There are now around 130 patients self-treating at home through the Plymouth service throughout the Peninsula.
“I’d also just like to acknowledge our admin team, as they have given amazing support with this additional work and we really couldn’t have achieved the work without them,” adds Natalie.