P708 Home-based infusion therapy for biologic agent administration as a therapeutic option for patients with inflammatory bowel disease. (16th January 2018)

• Record Type: Journal Article
• Authors: Madden, M; Pulusu, S S R; Lawrance, I
• Is Part Of: Journal of Crohn's and colitis. Volume 12:Number 1(2018:Jan.)Supplement 1
• Page Start: S469
• Page End: S469
• Publication Date: 2018-01-16
• Subjects: Inflammatory bowel diseases -- Periodicals; 616.344005
• DOI: 10.1093/ecco-jcc/jjx180.835
• Languages: English
• ISSNs: 1873-9946

Abstract

Abstract: Background: Chemo@Home is a home-based infusion service based in Western Australia. This study aims to assess the safety of Chemo@Home for infliximab and vedolizumab infusions in inflammatory bowel disease (IBD) patients, the cost of delivery and the level of patient satisfaction. Methods: IBD patients receiving infliximab and vedolizumab with Chemo@Home were assessed and any adverse effects noted. The cost of infusion by Chemo@Home was compared with private hospital administration and the activity-based funding in public hospitals. A patient satisfaction questionnaire assessed overall experience, infusion time and attitudes towards safety and accessibility. Safety was noted, with infusion reactions classified as minor, moderate or severe and managed according to treatment protocols. Results: This retrospective study evaluated 162 infliximab (29 patients, 19 patient-years) and 155 vedolizumab infusions (27 patients, 16 patient-years) with Chemo@Home from August 2014 to April 2017. There were six acute infusion reactions with infliximab (3.7%) in four patients. One of these was classified as a moderate reaction (0.62%) managed by IV hydrocortisone and an antihistamine, which resulted in the infusion not completed. The rest were minor reactions and all infusions were completed. Three acute infusion reactions occurred with vedolizumab (1.9%) and all were minor with all infusions completed. There were no episodes of anaphylaxis, no reactions requiring a doctor to attend and no hospital transfers. The price per infusion by Chemo@Home ($400–726AUS) was equivalent to the public ($527AUS) and overall cheaper than private hospitals ($316–$1793AUS). Patient satisfaction was higher with Chemo@Home compared with infusions in a private hospital ( p < 0.0001), infusion times were shorter ( p < 0.0001) with less parking issues ( p < 0.0001) and work or family life disruption ( p < 0.021). Analysis of the public hospital data is underway. Conclusions: Chemo@Home is safe with acute infusion reaction rates similar to previous studies. Costs are comparable to, or better than, the public and private hospitals. The service offers greater convenience and patient satisfaction to IBD patients receiving infliximab and vedolizumab.