Pharmaceutical Market Europe • January 2022 • 36-37

MEDICAL COMMUNICATIONS

Navigating evolving multiple sclerosis care during the COVID-19 pandemic

Lessons on the importance of adapting medical communications quickly

By Kirstie Park

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When the World Health Organization (WHO) declared COVID-19 a pandemic on 11 March 2020, it caused widespread disruption in the pharmaceutical and medical communications industries to an extent that had never been seen before. With local and international travel restricted, shifting work patterns as colleagues and clients worked from home, and key opinion leaders throughout the medical profession required on the hospital floor, plans for the year quickly came to a halt.

As the pandemic took hold, the carefully curated brand plans and strategic initiatives for 2020 were no longer tackling the key challenges faced by our clients. The role of the medical communications industry was to respond quickly to the changing circumstances and rapidly evolve brand strategic priorities to support clients in navigating this unexpected environment.

Shifting priorities in MS care

For people living with a pre-existing disease and the healthcare professionals (HCPs) managing their care, fears and questions about the real-world implications of this new infection for them, their disease and their treatment were of the highest priority.

In the field of multiple sclerosis (MS), there was an extensive list of new and unanswered questions that grew as the pandemic evolved. The importance of the effectiveness of treatments was displaced with an increased focus on overall safety. Initial concerns centred around whether people with MS were at an increased risk of contracting SARS-CoV-2 or experiencing a more severe infection, either due to their underlying MS or their disease-modifying treatment.

The delivery of care by MS specialist HCPs also experienced profound changes. In one nationwide survey of MS specialist HCPs in the US, not only were significant numbers redeployed to provide front-line COVID-19 care, but a large proportion spoke of an increased reliance on telemedicine for the remote management of their patients. It is suspected that these changes in routine clinical care influenced the prescribing behaviours of these HCPs as certain treatments were prescribed either more or less often than in the pre-pandemic period. It is yet to be determined what the long-term outcomes of these changes will be for patients.

The approval of
COVID-19 vaccines

The European Medicines Agency (EMA) approvals of the Pfizer/BioNTech, Moderna and AstraZeneca COVID-19 vaccinations at the turn of the year resulted in a whole new set of questions:

  • Should patients with MS be vaccinated
  • Are there any safety concerns with vaccination?

As vaccine roll-outs progressed, questions shifted to
vaccine response:
  • Will people with MS be able to mount a response to the vaccine?
  • If so, how long will it last?
  • What impact would their treatment have on this?

‘For people living with a pre-existing disease and the HCPs managing their care, fears and questions about the real-world implications of this new infection for them, their disease and their treatment were of the highest priority’

The fact that individuals with autoimmune disorders such as MS and/or those receiving disease-modifying therapies were not included in the vaccination pivotal trials offered no reassurance to HCPs or patients.

Most recently in the UK, with the recommendations that people with MS should receive a booster vaccination, and/or a third primary dose if they were severely immunosuppressed at the time of their first or second vaccines, HCPs are asking how best to time this with their patients’ MS treatment.

An initial lack of consensus from HCPs on the safety of the COVID-19 vaccination for people living with MS did not help to alleviate fears within the patient community. COVID-19 vaccination willingness was high in one survey of 401 people living with MS, however, nearly 30% were either unwilling or unsure about being vaccinated due to safety concerns. It was therefore more important than ever for the healthcare community to support and provide clear guidance to people living with MS.

Medcomms response to shifting priorities in MS care

In the absence of rigorous clinical trial data for managing and treating MS throughout the pandemic, there was an immediate need for real-world data to be collected and communicated efficiently.

As the first wave of the pandemic rippled through countries at different rates, HCPs in areas worst affected and where infection rates peaked earliest were able to collect, analyse and share their experiences with the rest of the world. For example, initial data from Iran, Italy and France published in June 2020 identified key clinical risk factors for severe COVID-19, assessed the impact of disease-modifying therapies on infection course and shared outcomes for people with MS who contracted the disease.

Over time, more and more real-world, single- and multicentre studies were carried out. COVID-19-specific databases were established to analyse findings across countries and identify any key patterns in patient outcomes. In spring of 2021, following the fast-tracked vaccine roll-out in Israel, the quick publication of vaccine response data of people with MS highlighted the differences in response to vaccination, according to the type of disease-modifying treatment received.

This data provided crucial insights and could be used to guide conversations with patients and in-clinic treatment decision-making in countries that were behind the curve in their vaccination roll-out. However, to be of maximum value, each piece of new information had to be shared as widely and as quickly as possible.

The importance of virtual peer-to-peer events

Without the option to hold international, large-scale, face-to-face events, virtual peer-to-peer events became the most effective way of quickly disseminating new data:
  

  • Collaborating with globally recognised experts in MS on a series of webinars allowed agencies to develop highly relevant events for HCPs, and providing them with a platform to share their own experiences offered the MS community guidance where data was lacking
  • Live Q&A sessions during each meeting offered a forum for HCPs to ask questions, share concerns and learn directly from each other
  • In addition, follow-up materials (such as post-meeting newsletters and video highlights shared online) provided further methods for re-emphasising take-home messages from each event.  

Addressing questions
and concerns from patients and HCPs

By adapting quickly to the changing circumstances, many of the concerns and questions from HCPs and patients were addressed proactively:

  • Post-meeting evaluations showed a significant increase in how confident HCPs felt when it came to managing their MS patients through treatment decisions and vaccination concerns, as a direct result of the data presentations they had watched and discussions in which they had taken part
  • • HCPs also reported that regular, localised events were of extremely high value as they provided an opportunity to address personal concerns about the specific stage of the pandemic they were in at the time
  • • In addition, there was an increase in website traffic as regular updates with new data releases and guidance assured HCPs that they had access to the most relevant, up-to-date information.

Beyond the
COVID-19 pandemic

As we look to the future and COVID-19 becomes endemic, communications will continue to evolve alongside the changing concerns of patients and HCPs. It is worth noting that results from a 2021 Nature survey of 925 HCPs showed that while most respondents were in favour of continuing digital programmes (74%), the relative lack of networking opportunities (69%) was perceived to be a clear detriment to post-pandemic meetings and events. Indeed, dig deeper and we can unearth countless perceived benefits, for example increased accessibility, lower carbon footprint and lower costs, as well as drawbacks, for example time-zone differences and complicated digital platforms of our new ‘virtual world’. This dichotomy will likely drive the facilitation of more hybrid events which, although relatively unknown territory, represent an exciting challenge that the medical communications industry should embrace wholeheartedly.

The past 18 months have shown that medical communications providers can adapt quickly to changing priorities and support clients in reaching their strategic goals despite incredibly challenging circumstances. There will no doubt be more questions and challenges in the future, however the role of medical communications will remain the same – to support and facilitate the rapid, effective communication of data to the medical community.

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Kirstie Park is
Senior Medical Writer at ClinicalThinking, part
of Nucleus Global