A nurse-led accelerated procedure for infliximab infusion is well tolerated and effective in patients with inflammatory bowel disease

Dig Liver Dis. 2015 May;47(5):372-7. doi: 10.1016/j.dld.2015.01.152. Epub 2015 Jan 30.

Abstract

Background: Shorter infusions of infliximab for inflammatory bowel disease seem to be as tolerated as standard procedures and nurses may be able to manage them safely.

Aims: To test tolerability and effectiveness of a fast nurse-led infusion procedure and the related patients' satisfaction.

Methods: We retrospectively compared three different regimens adopted in our outpatient infusion unit from 2010 to 2013: Group 1, a standard procedure with two-hour infusions, preceded by hydrocortisone medication (87 patients, 311 infusions); Group 2, a similar regimen without physician supervision (130 patients, 464 infusions); Group 3, a one-hour nurse-led procedure without routine premedication (176 patients, 1356 infusions). Disease characteristics, infusion reactions, infusions per month and patients' satisfaction were recorded.

Results: There were significantly fewer infusion reactions in Group 3 than Group 1 (2.2% versus 5.8% respectively; p=0.001). The only significant risk factor for side effects was premedication (odds ratio 4.71, 95% confidence interval 2.21-10.02, p<0.001) which was related to the presence of previous side effects. Number of infusions per month increased by 27% (83 versus 61, p<0.001) without increasing nurses' workload and patients were satisfied.

Conclusions: Our fast nurse-led procedure was well tolerated, effective and satisfactory for patients.

Keywords: Cost-benefit; Infusion reactions.

MeSH terms

  • Adult
  • Aged
  • Anti-Inflammatory Agents / administration & dosage
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use
  • Cost-Benefit Analysis / statistics & numerical data
  • Education, Nursing / methods*
  • Female
  • Gastrointestinal Agents / administration & dosage
  • Gastrointestinal Agents / therapeutic use
  • Home Infusion Therapy / adverse effects
  • Home Infusion Therapy / methods*
  • Humans
  • Hydrocortisone / administration & dosage
  • Inflammatory Bowel Diseases / drug therapy*
  • Infliximab / administration & dosage*
  • Infliximab / therapeutic use
  • Male
  • Middle Aged
  • Outpatients
  • Patient Satisfaction / statistics & numerical data*
  • Physician's Role
  • Practice Patterns, Nurses'*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Gastrointestinal Agents
  • Infliximab
  • Hydrocortisone