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Shielded patients able to continue life-transforming treatment


Posted on Tuesday 7 July 2020
20200707, Justin Ikpeamagheze

Justin Ikpeamagheze

Hundreds of severe asthma patients have been able to take their life-changing drugs throughout the COVID-19 crisis thanks to quick-thinking hospital staff.

The severe asthma team at Guy’s and St Thomas’ led by Dr David Jackson worked rapidly so that patients on biological treatments, which are usually injected by staff in hospital, could administer the medicines themselves at home.

This group of patients were among those told to shield by the Government, so without this approach they would have had to stop taking the treatment or go against official guidance by coming into the hospital.

Justin Ikpeamagheze, 36, from Norbury in south-west London, has severe asthma and has been shielding throughout the COVID-19 outbreak. He has taken one of the biologic therapies for around two years, having previously suffered from a huge asthma attack which left him in an induced coma.

Justin, a teacher and actor, said: “I was diagnosed with asthma when I was 13 but I never took it that seriously and it didn’t affect me much. Then in my late-20s my asthma started to get worse and aged 31 I had a major asthma attack which left me in an induced coma for nine days.

“When I woke up it was difficult for me to accept what had happened. My asthma was much worse than I realised. I’d never had an asthma attack before. You never know if it’s going to happen to you.

“I’m very active so it never occurred to me that it would hit me one day. It took a long time to recover mentally and I started to become anxious and more wary of things. I felt like I was out of sync and needed to reboot – it was quite an ordeal.”

Around two years ago he started taking one of the biologic treatments, benralizumab. Biologic therapies target a specific inflammatory cell of the immune system called the eosinophil that causes inflammation in the airways of people with asthma. They are more precise than steroids and do not affect the rest of the immune system, consequently causing far fewer side-effects.

Justin, who has injections of the drug every eight weeks, said: “The treatment has made a big difference to me. I can now do most things again as I could before my asthma attack. The drugs have allowed me to live a normal life, be active, have a full-time teaching job and continue my acting and directing career. I’ve built up my confidence and can do things I want to do now. I’m so much better now.

“I was worried about accessing my injections during lockdown. I called the clinic and they were really helpful. They sorted it all for me and arranged for my injections to be delivered on a two-monthly basis. They explained how to inject them and offered to send a nurse to do it but I was confident that I could do it, or that my girlfriend could.

“It was very reassuring to know I could still take them. The clinic followed up and made sure everything was ok with them, and they also provided shielding advice as I was concerned about returning to work. So far I’ve been able to work from home.

“I’m very grateful to the team, it really feels like they have my best interests at heart. They made what could have been a more stressful time a lot easier for me.”

Gráinne d’Ancona, consultant pharmacist for the severe asthma team, said: “Biologic therapies have been transformational in the care of people with severe asthma. They reduce symptoms and the frequency of asthma attacks, and therefore minimise steroid tablet exposure and their resultant side-effects. Our patients rely on them and their inhalers.

“With that in mind, we were determined to get these important treatments to our patients safely while ensuring they felt supported at a very frightening time.

“In a two-week period we arranged for these injections to be delivered to more than 400 patients’ homes. We made sure they knew how to administer them using virtual technology or in person at their homes, were happy to do so and were in contact with them regularly in case they had any concerns or just to check in and answer any questions.

“This transition to home administration would usually take more than six months to organise, so it really was a fantastic team effort and was very empowering for our patients.

“Having successfully implemented this change at Guy’s and St Thomas’, we are now supporting other centres with less resource to do something similar for their patients.”

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