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An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions

  • J.-P. Doran
  • S. Alraqi
  • I. Callanan
  • O. FitzGerald
  • B. Bresnihan
  • D. J. Veale
Brief Report
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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Inflammatory arthritis Infliximab Monoclonal antibody Anti TNF-alpha Community infusion unit Intravenous infusion 

References

  1. 1.
    Kievit W, Fransen J, Oerlemans AJ, Kuper HH, van der Laar MA, de Rooij DJ, De Gendt CM, Ronday KH, Jansen TL, van Oijen PC, Brus HL, Adang EM, van Riel PL (2007) The efficacy of anti-TNF in rheumatoid arthritis, a comparison between randomised controlled trials and clinical practice. Ann Rheum Dis 66(11):1473–1478. doi: 10.1136/ard.2007.072447 CrossRefPubMedGoogle Scholar
  2. 2.
    Manadan AM, James N, Block JA (2007) New therapeutic approaches for spondyloarthritis. Curr Opin Rheumatol 19(3):259–264CrossRefPubMedGoogle Scholar
  3. 3.
    Boehncke WH, Prinz J, Gottlieb AB (2006) Biologic therapies for psoriasis. A systematic review. J Rheumatol 33(7):1447–1451PubMedGoogle Scholar
  4. 4.
    Panés J, Gomollón F, Taxonera C, Hinojosa J, Clofent J, Nos P (2007) Crohn’s disease: a review of current treatment with a focus on biologics. Drugs 67(17):2511–2537CrossRefPubMedGoogle Scholar
  5. 5.
    Corwin P, Toop L, McGeoch G, Than M, Wynn-Thomas S, Wells JE, Dawson R et al (2005) Randomized controlled trial of intravenous antibiotic treatment for cellulitis at home compared with hospital. BMJ 330:129. doi: 10.1136/bmj.38309.447975.EB CrossRefPubMedGoogle Scholar
  6. 6.
    Grayson ML, Silvers J, Turnidge J (1995) Home intravenous antibiotic therapy. A safe and effective alternative to inpatient care. Med J Aust 162(5):249–253PubMedGoogle Scholar
  7. 7.
    Nathwani D, Morrison J, Seaton RA, France AJ, Davey P, Gray K (1999) Out-patient and home-parenteral antibiotic therapy (OHPAT): evaluation of the impact of one year’s experience in Tayside. Health Bull (Edinb) 57(5):332–337Google Scholar
  8. 8.
    Coyte PC, Dobrow MJ, Broadfield L (2001) Incremental cost analysis of ambulatory clinic and home-based intravenous therapy for patients with multiple myeloma. Pharmacoeconomics 19(8):845–854. doi: 10.2165/00019053-200119080-00006 CrossRefPubMedGoogle Scholar
  9. 9.
    van Eijk Y, Boonen A, Schulpen G, Schrijnemaekers V, Fiolet H, van der Linden S (2006) Safety and patient satisfaction of infliximab administration in an extramural setting supervised by a rheumatology specialist nurse. Ann Rheum Dis 65:276. doi: 10.1136/ard.2005.036566 CrossRefPubMedGoogle Scholar
  10. 10.
    Condino AA, Fidanza S, Hoffenberg EJ (2005) A home infliximab infusion program. J Pediatr Gastroenterol Nutr 40(1):67–69. doi: 10.1097/00005176-200501000-00012 CrossRefPubMedGoogle Scholar
  11. 11.
    Stuby U, Biesenbach G, Pieringer H (2007) Administration of infliximab in general practitioners’ offices is safe. Clin Rheumatol 26(11):1863–1866. doi: 10.1007/s10067-007-0590-5 CrossRefPubMedGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2009

Authors and Affiliations

  • J.-P. Doran
    • 1
  • S. Alraqi
    • 1
  • I. Callanan
    • 2
  • O. FitzGerald
    • 1
  • B. Bresnihan
    • 1
  • D. J. Veale
    • 1
  1. 1.Department of RheumatologySt Vincent’s University Hospital (SVUH)DublinIreland
  2. 2.Department of Clinical AuditSt Vincent’s University Hospital (SVUH)DublinIreland

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