Monoclonal Antibody Call Script

Hello, my name is --- and I am a (physician, nurse practitioner, nurse, pharmacist etc) calling from Gallup Indian Medical Center to follow up with you after you were tested for COVID-19. Has anyone been able to reach you yet regarding your test result?

If no, please discuss items on bottom of page 2 before proceeding to monoclonal antibody discussion.

If yes and patient is aware of positive result:

Has anyone talked with you yet about treatment for COVID-19? We have several different outpatient treatments now for COVID-19 but based on your medical history, a medication called monoclonal antibody therapy may be the best choice. Monoclonal antibody therapy works better the sooner we can give it after someone’s symptoms start. Can I verify with you what day you first started having symptoms? Please note that the first day of symptoms is day 0

If patient has already been symptomatic for >7 days or has no symptoms they are not eligible for this treatment. If the patient has no symptoms at this time but would otherwise be eligible for treatment please provide them with the number to the COVID Therapeutics cell phone where they can call back ASAP if any symptoms do develop.

If the patient does have symptoms that have been present for less than 7 days please screen them for medical eligibility starting with BMI.

If the patient is eligible for treatment: 

Can I give you some information about the monoclonal antibody treatment to see if you might be interested?”

It’s a medication that is given through an IV. For patients who are interested they come to the hospital for an appointment and they’re usually here for about 2 hours getting the treatment and then they go home afterwards. The medication works by giving the body extra antibodies, which is what our white blood cells (part of the immune system) naturally make to fight off infections like viruses. This is a medication that will give your body extra antibodies against the virus that causes COVID-19 to help your body fight off the virus faster and better. It makes people’s symptoms go away more quickly and it also reduces the chance that the virus can get worse to where a person may need to come into the hospital, or even die from COVID-19. At Gallup Service Unit we are currently using a new monoclonal antibody medication called bebtelovimab because it is the only monoclonal antibody drug that is active against the BA.2 variant. Because bebtelovimab was developed fairly recently we don’t know have good studies yet showing by what percentage it decreases the chance of hospitalization or death but it works in a very similar way to other monoclonal antibody drugs we’ve used in the past called REGEN-COV and sotrovimab that reduced the risk of hospitalization or death by 70-85% so we think the effect of bebtelovimab should be very similar.

It’s extremely rare to have any side effects from this medication, but just like anyone can be allergic to any medication, in the clinical trials when they were developing this treatment there were a very small number of people (1 out of every 900 people) who turned out to be allergic to the medication and had an allergic reaction to it. It’s extremely rare for that to happen, but we let our patients know that when you’re getting the medication your nurse will be observing you the whole time. If you start to feel like you’re getting itchy or getting a rash or your lips feel itchy or swollen, just let your nurse know right away and that way they can give you some allergy medication to shut down any kind of allergic reaction. That’s extremely rare for that to happen but that’s the only possible side effect of the medication so it’s good to know about it.

The other thing that’s also good to be aware of with this medication is that, just like all of the treatments we have for COVID-19, this medication was developed in the past year and a half. Because of that, it hasn’t been out long enough yet to get full FDA approval. That’s because the complete approval process through the Food and Drug Administration (the FDA) takes several months to years to complete. For that reason this medication is under what’s called “emergency use authorization” by the FDA.

Is this medication something you think you might be interested in?

If no, please let the patient know where to call back in case they change their mind but let them know the medication does work better the sooner it is given after symptom onset so to call back ASAP.

If yes:

Great. I will place a referral for you for the COVID ambulatory infusion clinic and they will call you to help you schedule an appointment. You don’t have to call them, they will call you, but just in case you have trouble connecting with them or miss their call you can reach them at 505-722-1553 to make sure you get scheduled. Can I confirm the best number where they can reach you?

When you enter a COVID Ambulatory Infusion Consult make sure to text the COVID infusion clinic RN at 505-979-1765 to make them aware of the consult so they can call the patient to schedule the first appt ASAP. Please also make sure the patient has transportation to the appointment. If no transportation is available and patient lives within 1.5 hours of downtown Gallup you can refer to One Care home infusion by faxing a prescription and face sheet to One Care Infusion Pharmacy at 505-726-4304. Please indicate on the prescription that the patient needs home infusion (otherwise they will try to set patient up for infusion in their pharmacy at 907 W Coal Ave).  You will also need to complete the RCIS/Transfers Referral as well.

If patient is not yet aware of their COVID test result

1. Make patient aware of test result
2. Briefly discuss isolation requirements
3. Briefly discuss testing of close contacts (within 6 feet for >15 minutes with or without a mask during patient’s infectious period which starts 48 hours prior to symptom onset). Contacts should test immediately and again at day 5-7 after exposure (or sooner if any symptoms develop)