022 Piloting home infusions of natalizumab: a randomised crossover trial
| Autor: | Paul Georgiou, Lynette Cusack, Kerisha Naidoo, Lorraine Simon, Mahasen Juaton, Kevin Webb, Janakan Ravindran, Anne Thomas, Tim Schultz, Jon Karnon |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
030504 nursing Clinical effectiveness Treatment adherence business.industry Crossover study 03 medical and health sciences Psychiatry and Mental health Patient safety 0302 clinical medicine Natalizumab Patient satisfaction Quality of life Emergency medicine medicine Surgery 030212 general & internal medicine Neurology (clinical) 0305 other medical science Adverse effect business medicine.drug |
| Zdroj: | Journal of Neurology, Neurosurgery & Psychiatry. 89:A10.1-A10 |
| ISSN: | 1468-330X 0022-3050 |
| DOI: | 10.1136/jnnp-2018-anzan.22 |
| Popis: | IntroductionFor people with multiple sclerosis, monthly infusions at specialist clinics are time consuming, potentially costly and restrictive. Conversely, increased demand for hospital services is driving innovation, including delivery of care in the home. We developed a rigorous model of care for home infusions of natalizumab, which was evaluated in a randomised crossover trial. This pilot study (i) tested feasibility and safety of home infusions, and (ii) compared acceptability and clinical effectiveness with usual clinic-based care in a hospital outpatients clinic.MethodsWe recruited 37 stable adult patients (at least 6 prior natalizumab infusions and assessed as safe by their neurologist) who were randomised to an AB or BA trial arm. After 3 infusions, patients crossed over to the alternate treatment for another 3 infusions. The following outcomes were assessed treatment adherence, patient safety outcomes, quality of life (Multiple Sclerosis Quality of Life Inventory, MSQLI), and patient satisfaction (Treatment Satisfaction Questionnaire for Medication, TSQM).ResultsTwo patients moved out of Adelaide and withdrew. No adverse events resulting from the infusion in either the home or clinic setting were reported. There was no difference between home and clinic in the adherence rate (86/104, 82.7% at home) and (84/103, 81.6% at clinic) (X2=0.0, p=1.0) and number of infections during home care8 compared to clinic10 (X2=0.04, p=0.84). There was no difference in any of the nine sub-scales of the MSQLI (p>0.05). Of the four sub-scales of the TSQM (‘Effectiveness’, ‘Side effects’, ‘Convenience’, ‘Global satisfaction’), patients most recently receiving home care were significantly more satisfied with the Convenience of their treatment (p=0.0008).ConclusionData from the pilot study suggest that delivery of infusions of natalizumab at home is feasible, safe and as effective as the hospital setting. Patients reported that home infusions were more convenient than the clinic. |
| Databáze: | OpenAIRE |
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