Intravenous Home Infusion Therapy Instituted From a 24-Hour Clinical Decision Unit For Patients With Cellulitis

Developing a Model of Care for Home Infusions of Natalizumab for People With Multiple Sclerosis

“…This proposed model of care reflects other home care initiatives designed to improve efficiency, patient centeredness, safety, and quality, while reducing health care costs and meeting greater demand. 21 Treatments that have recently been shown to be safe and efficacious when delivered at home include IV antibiotics for cellulitis, 41 enzyme replacement therapy for Gaucher disease 56 and Fabry disease, 17 and complex chemotherapy in acute leukemia and lymphoma. 38 Possible benefits from home care include improved adherence to treatment, better quality of life and clinical outcomes, reduced health system costs, and greater convenience to patients.…”

“… 32 A search for relevant evidence (“preclinical or theoretical phase”) was first conducted in March 2016 and updated in June 2018. PubMed, Scopus, Cochrane Library, Joanna Briggs Institute, and Cumulative Index to Nursing and Allied Health Literature databases were searched using search terms and medical subject headings including “home infusion”; “home care”; “natalizumab”; “monoclonal antibody”; “adverse events”; “IV infusion”; “multiple sclerosis”; and “home care services.” The search identified 35 published studies relevant to the aims of this study, including studies in 5 main topics: safety and adverse effects of natalizumab, 2 , 4 – 13 home care, 19 – 22 , 33 – 36 home infusions, 18 , 24 – 28 , 37 – 41 infusion guidelines and standards, 15 , 42 and medication management. 43 In addition to relevant published studies, product information, 3 training guides, 44 Australian health care standards, 45 and organizational protocols 16 were included, and US infusion therapy standards 46 were reviewed for applicability in the Australian setting.…”

Route and duration of antibiotic therapy in acute cellulitis: A systematic review and meta-analysis of the effectiveness and harms of antibiotic treatment

“…Eleven studies, including those treated as outpatients/OPAT, reported an average length of IV therapy of 2-7 days and an average overall treatment duration of 6-10 days. [59][60][61][62][63][64][65][66][67][68][69] Clinical response rates ranged from 85-97%, failure rates from 5-22% and recurrence rates from 0-6%.…”

Home infusions of natalizumab for people with multiple sclerosis: a pilot randomised crossover trial

“…12 , 13 , 14 , 15 Infusion therapy at home began in the 1970s with parenteral nutrition and intravenous immunoglobulin, and has more recently expanded into other diseases and treatments, including cancer and cellulitis. 16 , 17 , 18 A systematic review of home infusion therapy concluded that home infusions were safe and clinically effective, resulted in significantly lower costs and were overwhelmingly preferred by patients because of increased physical and mental wellbeing and decreased disruption of family and personal responsibilities. 19 Although uptake of home infusions of monoclonal antibodies has lagged other forms of treatment such as antibiotic therapy, 19 home infusions of infliximab have been demonstrated to be safe and cost‐effective for children and adults with Crohn’s disease 20 , 21 and, more recently, natalizumab has been delivered by infusion at home for people with MS. 22 …”

“…Such benefits include reduced incidence of nosocomial infection; greater convenience, comfort, choice and flexibility and patient‐centred care; and reduced stress and out‐of‐pocket expenses 12–15 . Infusion therapy at home began in the 1970s with parenteral nutrition and intravenous immunoglobulin, and has more recently expanded into other diseases and treatments, including cancer and cellulitis 16–18 . A systematic review of home infusion therapy concluded that home infusions were safe and clinically effective, resulted in significantly lower costs and were overwhelmingly preferred by patients because of increased physical and mental wellbeing and decreased disruption of family and personal responsibilities 19 .…”