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Short report
Paediatric severe asthma biologics service: from hospital to home
  1. Sukeshi Makhecha1,
  2. Angela Jamalzadeh1,
  3. Samantha Irving1,
  4. Pippa Hall1,
  5. Samatha Sonnappa1,
  6. Sejal Saglani1,2,
  7. Andrew Bush1,2,
  8. Louise Fleming1,2
  1. 1 Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
  2. 2 Imperial College London, London, UK
  1. Correspondence to Dr Louise Fleming, Paediatric Respiratory Medicine, Royal Brompton Hospital., London SW3 6NP, UK; l.fleming{at}rbht.nhs.uk

Abstract

Children with severe asthma may be treated with biologic agents normally requiring 2–4 weekly injections in hospital. In March 2020, due to COVID-19, we needed to minimise hospital visits. We assessed whether biologics could be given safely at home. The multidisciplinary team identified children to be considered for home administration. This was virtually observed using a video link, and home spirometry was also performed. Feedback was obtained from carers and young people. Of 23 patients receiving biologics, 16 (70%) families agreed to homecare administration, 14 administered by parents/patients and 2 by a local nursing team. Video calls for omalizumab were observed on 56 occasions, mepolizumab on 19 occasions over 4 months (April–July). Medication was administered inaccurately on 2/75 occasions without any adverse events. Virtually observed home biologic administration in severe asthmatic children, supported by video calls and home spirometry, is feasible, safe and is positively perceived by children and their families

  • pharmacology
  • nursing care
  • COVID-19

Data availability statement

Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information. This is a service delivery evaluation and as a result there are no study protocols or statistical analysis plans.The data does not include any participant details and relevant data have been included in this article. Further clarification may be sought from the corresponding author.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/archdischild-2020-320626

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    Data availability statement

    Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information. This is a service delivery evaluation and as a result there are no study protocols or statistical analysis plans.The data does not include any participant details and relevant data have been included in this article. Further clarification may be sought from the corresponding author.

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    Footnotes

    • Twitter @SukeshiMakhecha

    • Contributors Concept and design: SM, AJ, LF, AB, PH, SamS. Data acquisition: AJ, SI, SM. Data analysis: SI, AJ, SM, AB, LF. Data interpretation: SM, AJ, LF, AB, SamS, SejS. All authors edited the manuscript and approved the final draft.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.