Safety and patient satisfaction of infliximab administration in an extramural setting supervised by a rheumatology specialist nurse.

Department of Integrated Care, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Annals of the Rheumatic Diseases (Impact Factor: 9.11). 03/2006; 65(2):276. DOI: 10.1136/ard.2005.036566
Source: PubMed
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    ABSTRACT: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent's University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.
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    ABSTRACT: Tocilizumab is an effective therapy for patients with moderate to severe rheumatoid arthritis that is administered by infusion over one hour every 4 weeks. The community-based infusion (ACTiv) program was introduced to Australia in August 2010 to provide accessible and convenient treatment for patients with rheumatoid arthritis who require tocilizumab. The primary objectives of this study were to determine the characteristics of patients in the ACTiv program, patient satisfaction, and patient-perceived benefits and concerns with the ACTiv program, and drivers of patient satisfaction and patient-perceived benefits and concerns. A voluntary self-administered survey was given to all 608 patients in the ACTiv program between January 27, 2011 and March 31, 2011. A total of 351 surveys were returned completed, giving a response rate of 58% (351/608). Most patients in the ACTiv program were women aged 40-64 years, with a mean disease duration of 13.7 years and moderate disability, who had been in the ACTiv program for ≥5 months. Most patients (88%, 302/342) were either very satisfied or satisfied with the ACTiv program and believed that they were very unlikely or somewhat unlikely to switch from the ACTiv program (64%, 214/335). The most important benefit was the reassurance of receiving treatment from a trained nurse in a professional medical environment (33%, 102/309). The most important concern was the fear of side effects (48%, 134/280). The main drivers of patient satisfaction and patient-perceived benefits and concerns of patients were health profile, previous medication experience, and length of treatment time in the program. The ACTiv program is used by patients of various ages, family life situations, and locations. Patient satisfaction with the program is high, which enables patients to benefit from long-term use of tocilizumab.
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Jul 24, 2014