COVID-19: Vaccine Program | TestingVisitor Guidelines | Information for Employees

COVID-19 Treatment Program

Updated 1/12/2022

Latest Guidance for Providers on COVID-19 Emerging Therapies

Guidance Contains:

  1. Summary
  2. Eligibility Criteria
  3. Workflow Overview
  4. Additional Guidance

Summary

UConn Health has launched a new virtual COVID-19 Treatment Program to help medical providers assist their eligible highest-risk patients in gaining potential access to prescriptions, for the latest emerging COVID-19 medical therapies to fight the virus.

In November 2020, UConn Health first started offering monoclonal therapy infusion to high-risk COVID-positive patients. On December 20, 2021 nirmatrelvir/ritonavir (PAXLOVID) and molnupiravir (Lagevrio) were granted emergency authorization (EAU) use by the FDA. Distributions of these outpatient medications are expected to UConn Health as periodically as national supplies allow. On December 31, 2021 UConn Health first began offering oral therapy for COVID-19-positive outpatients at high-risk of severe disease progression and hospitalization.

Providers can now order AMB COVID Antiviral Order Review for high-risk patients, who they think may benefit from outpatient therapy for COVID-19 via a comprehensive review process. Each patient will be vetted as possible candidates to receive either monoclonal antibody therapy or one of these oral antiviral medications.

Note: Currently, medications are in very limited supply, and therefore clinical review and prescribing will be restricted to only our highest-risk patients.

We are prioritizing patients who are at highest-risk and those with multiple comorbidities.

Eligibility Criteria

Outpatient therapies are currently prioritized and restricted to those who are at highest-risk of severe disease and hospitalization, including the following:

  • Age > 65, especially >75
  • Elevated BMI, especially BMI > 35
  • Medical conditions such as:
    • Diabetes mellitus
    • Chronic kidney disease
    • Hypertension, heart failure, coronary artery disease, cardiomyopathies, or chronic respiratory disease with age > 55
    • Immunocompromising medical condition
    • Medication or chemotherapy leading to immune compromise
  • Unvaccinated or incompletely vaccinated
  • Pregnancy

Note: As supply becomes more readily available, criteria will expand to include other groups based on risk. We expect supply to increase as these medications will play a growing role against COVID-19 and its variants such as omicron. Once oral medications are more widely available, it is expected that providers will be able to write prescriptions for these medications through Epic.

Workflow Overview

To put in an order for a qualifying, high-risk patient to UConn Health’s virtual COVID-19 Treatment Program:

Step 1: Provider speaks with the patient and confirms their interest in exploring treatments. To be eligible, the patient must have symptoms compatible with COVID-19, a positive test for COVID-19, and be within 5 days since symptom onset for oral therapy or within 7 days for monoclonal antibody therapy. The date of symptom onset is “day 1.” At this time, a PCR or rapid antigen test with compatible symptoms suffices for consideration.

Important Note: Because demand for the therapies is expected to exceed weekly supply availability, providers should inform patients upfront that they may not get a call-back because of the prioritization of the highest-risk patient referrals. Here is the approved verbiage from the Health Compliance department: We are currently determining eligibility based on several high-risk categories in relation to available supply. We will contact you if you are determined to be eligible. The medical team will call the highest-priority patients as time and supply allows.

Step 2: Provider places order for AMB COVID Antiviral Order Review. The Epic order guides the ordering provider through the required screening information, which must include the following patient information:

  • Vaccination status.
  • Symptom onset date.
  • Test positive date.
  • Pregnancy status.
  • Risk factors for severe disease, including medical illnesses and medications.

Step 3: The Pharmacy team performs and documents an extensive medication reconciliation and dispensary review. The Pharmacy team will forward their telephone message to the COVID Care Team via an InBasket pool “p Covid Antiviral Provider” for further review.

Step 4: Qualifying COVID positive patients will be called by a member of the COVID-19 Care Team. The COVID-19 Care Team provider will have a telephone encounter with the patient to review the therapy options, obtain verbal consent from the patient, and place an order for prescribing either:

  • the oral antiviral therapy to the UConn Health Specialty Pharmacy or
  • for scheduling a monoclonal antibody IV therapy infusion

The COVID-19 Care Team provider, selects charges, and signs the order and the note to close the encounter.

The COVID-19 Care Team provider updates the excel spreadsheet slot in the COVID Care Team folder on the NSOFS10 shared drive, along with the MRN in the appropriate therapy column.

Step 5:

For Monoclonal Antibody Therapy Patients: The COVID-19 Care Team provider creates an Orders Only encounter and uses the “MORE” button to create orders for the hospital. The provider will use the AMB COVID Monoclonal Antibody Therapy order set to create the IV therapy medication order for the patient. A UConn Health resource will call the patient to schedule the Monoclonal IV Therapy with the UConn UT4 Therapeutic Clinic.

or

For Oral Antiviral Therapy Patients: The UConn Health Specialty Pharmacy will dispense the oral antiviral medication and arrange delivery or pick up by designated party.