Interprofessional team key in roll out of new Alzheimer’s therapy

“Our work shows an interprofessional team plays an important role in the clinical care and management of patients taking new disease-modifying medications for Alzheimer’s disease,” said Dr. Katherine Turk, first author of the paper, “An Interprofessional Team for Disease Modifying Therapy in Alzheimer’s Disease Implementation,” and a neurologist and researcher at VA Boston HCS and the Boston University Alzheimer’s Disease Research Center. 

Lecanemab is one of the first FDA-approved medications to clear amyloid-beta from the brain, representing a major advance in the Alzheimer’s field. Amyloid-beta is one of the main proteins that builds up in Alzheimer’s disease and Lecanemab has demonstrated in clinical trials that it can slow cognitive decline in the early-stages of Alzheimer’s disease. However, the medication involves infusions at a center and is not without risks, as there can be infusion-related reactions or, rarely, brain swelling or bleeding. Risks and benefits must be communicated to patients and their loved ones so they can make informed decisions, and care coordinated among a team of clinical providers to minimize risks. 

While available to Veterans and clinicians in the VA healthcare system since fall 2023, new clinical systems and practices were needed to facilitate rollout of the new medication, and appropriately screen and monitor patients. The disease modifying therapy in Alzheimer’s disease, or DMTAD, team at VA Boston was formed to address these needs. Behavioral neurologists (attendings and fellows), pharmacists (attendings and residents), infusion nurses, geriatricians, a physician assistant, and a neuroradiologist meet weekly for an hour to review the prior week’s infusions, eligible patients, and interval magnetic resonance imaging performed as part of safety monitoring. Notes are written in the medical record as appropriate. 

Medical documentation templates, protocols and policies, as well as patient education handouts, were developed by the group and are available as supplementary materials in the publication, so others throughout VA and other U.S. medical systems can benefit from and adapt these resources for their own use. 

“We were the first VA site to roll out Lecanemab, so we needed to develop policies, procedures and handouts,” added Dr. Andrew Budson, senior author of the paper, chief of Cognitive Behavioral Neurology at VA Boston HCS and professor of neurology at Boston University Chobanian & Avedisian School of Medicine. “We found that the DMTAD team was key in rolling out the therapy efficiently. Our ongoing weekly meetings allow us to safely monitor patients who are on this new medication.”

The study is available at https://www.neurology.org/doi/10.1212/CPJ.0000000000200346

Photo caption (photo linked below):

Dr. Katherine Turk and Dr. Andrew Budson, neurologists and clinical researchers at VA Boston Healthcare System and the Boston University Alzheimer’s Disease Research Center, review an amyloid PET scan for a potential patient they are considering for Lecanemab infusion at VA Boston’s Jamaica Plain campus June 24, 2024. (VA Boston HCS photo by Winfield Danielson)

Winfield Danielson, Public Affairs Officer

Phone: