Home-based infusion therapy - A feasible approach for chronically ill patients? A new path to provide superior patient care exemplified for Fabry's disease [Infusionsbehandlung in h?uslicher Umgebung - ein praktikabler Ansatz für chronisch Kranke?: Neue Wege der Versorgung am Beispiel des Morbus Fabry]

摘要

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.