[Home-based infusion therapy--a feasible approach for chronically ill patients? A new path to provide superior patient care exemplified for Fabry's disease]

Dtsch Med Wochenschr. 2013 Nov;138(46):2345-50. doi: 10.1055/s-0033-1349624. Epub 2013 Nov 5.
[Article in German]

Abstract

Background: As there are scarce data from Germany addressing home-based infusion therapy in chronically ill patients, a study on transferring infusion therapy from in-patient-treatment to home care, exemplified for Fabry's disease, was conducted.

Methods: A total of 69 patients on enzyme replacement infusion therapy (ERT with agalsidase alfa every two weeks) were enrolled in the open, non-controlled, multicentre, non-interventional observational study. After uneventful ERT in a hospital setting, intravenous treatment was administered at home by a specially-trained nurse. Primary outcome measure was change in patient satisfaction measured by an eleven-item Likert scale.

Results: The in-home observation period lasted between 96 und 401 days (median 180; IQR 166-184). Patient satisfaction increased significantly with home-based therapy (p = 0.001). A quality of life analysis (SF-36) demonstrated significant improvements in role-physical (p = 0.003), bodily pain (p = 0.032), vitality (p < 0.001), social functioning (p = 0.020), role-emotional (p = 0.007), mental well-being (p = 0.007) and mental sum score (p = 0.002). Home infusions turned out to be safe and were well tolerated.

Conclusion: Chronically ill patients with need for regular infusion therapy may benefit from a home care setting. Home-based infusion therapy as exemplified by agalsidase alfa ERT in Fabry's disease is a viable option for patients who received uneventful infusions within the hospital.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Chronic Disease / therapy*
  • Critical Pathways / statistics & numerical data
  • Fabry Disease / diagnosis
  • Fabry Disease / drug therapy*
  • Fabry Disease / epidemiology*
  • Feasibility Studies
  • Female
  • Germany / epidemiology
  • Home Care Services / statistics & numerical data
  • Home Infusion Therapy / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Humans
  • Infusions, Intravenous
  • Isoenzymes / administration & dosage
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Quality of Life*
  • Recombinant Proteins
  • Risk Factors
  • Treatment Outcome
  • Young Adult
  • alpha-Galactosidase / administration & dosage*

Substances

  • Isoenzymes
  • Recombinant Proteins
  • agalsidase alfa
  • alpha-Galactosidase