By: Option Care
March 12, 2019
ORLANDO, Fla., March 11, 2019 — New research by Option Care Enterprises, Inc. (“Option Care”), the nation’s leading provider of home and alternate site infusion therapy services, suggests the method of antibiotic intravenous (IV) administration can improve patient compliance while decreasing costs. The study[*]Wurdeman J, Decaminada G, Andrusko-Furphy K, et al. Comparison of compliance and comprehensive cost for various methods of administration of intravenous antibiotics in a home infusion setting. Poster presented at the National Home Infusion Association (NHIA) Annual Conference; March 9-13, 2019, Orlando, Fla. was presented today at the National Home Infusion Association (NHIA) Annual Conference and is a finalist for the “Outstanding Abstract Achievement Award.
The researchers analyzed patient compliance by comparing four techniques for antibiotic self-administration and determined ease of providing therapy was a significant factor. They concluded patients were significantly more likely to comply with therapy if they used the elastomeric pump or IV push than if they used the gravity/mini bag or electronic pump. Additionally, in many cases IV push and elastomeric pump are less costly.
“There’s a common perception that the gravity/mini bag is the least expensive method, but our research shows not only are IV push and elastomeric pump often more cost-effective, but patients find them easier to use, decreasing the likelihood that they will skip doses, which can lead to failed therapy and hospital readmission,” said Julie Wurdeman, PharmD, an Option Care infusion pharmacist and primary author of the study. “Our findings have implications for helping establish the most appropriate method of administration and underscore the value of collaboration among patients and the care team.”
The type of IV antibiotic therapy typically is chosen by the pharmacist in collaboration with the physician and determined by several factors including the medication, frequency of therapy (typically one to three times a day), rate of infusion as well as provider preference, patient lifestyle and age. The research suggests that patient compliance and cost should be factored into the equation.
Researchers studied treatment compliance in 688 Option Care home infusion patients who were treated between October 2017 and October 2018 and who missed one or more doses of IV antibiotics. They found the percentage of doses missed by technique was: 2.6 percent elastomeric pump, 2.7 percent IV push, 5 percent mini bag and 8.6 percent electronic pump.
There is a wide variation between methods in the cost of administration (factoring in equipment, compounding and patient education, but not medication), including a 209 percent difference between the least-expensive, IV push, and the most-expensive, electronic pump. The cost varies depending on the number of times per day and the rate at which the antibiotic is provided, as well as whether equipment can be reused and other factors.
In home antibiotic therapy, the patient infuses the medication through a catheter (placed by a nurse in a vein, usually in the hand or arm). The medication typically is administered one of four ways:
- IV push: The patient injects the medication via a syringe. This process is easy to learn, portable and fast.
- Elastomeric pump: The tennis ball-sized device comes pre-filled with the medication and self-squeezes it through tubing into a port the patient inserts into the catheter. This technique is easy to learn, precise and portable.
- Gravity/mini bag: The patient hangs the bag of medication on a pole and inserts the end of the tube into the catheter. The equipment involves set-up and is bulky, so it is not easily portable.
- Electronic pump: The patient connects the medication to the pump as well as the tube into the catheter and turns on the pump. The equipment involves set-up and is bulky, requiring the patient to carry the pump wherever he or she goes.
“While the type of antibiotic and rate of administration are the most important factors in determining the method of administration, in many cases there is flexibility,” said Wurdeman. “It’s important to consider all factors — including patient preference — which can help improve compliance and decrease costs.”
For its first Outstanding Abstract Achievement Award, the National Home Infusion Foundation chose abstracts that examine an innovative approach to clinical practice; identify a best practice or improve quality; are relevant to a current challenge, issue or question facing the home infusion industry; employ an effective study design/methodology to achieve results and have the ability to be expanded to a larger study.
Another Option Care study[*]Cheung K, Rout T, Banerjee U, et al. A Retrospective Evaluation of the Frequency of Vancomycin Monitoring and its Effects on Home Infusion Patients. Poster presented at the National Home Infusion Association (NHIA) Annual Conference; March 9-13, 2019, Orlando, Fla. being presented at NHIA compared results associated with frequency of therapeutic drug monitoring (TDM) among 100 patients treated with home infusion of high-dose vancomycin (a commonly prescribed antibiotic), half of whom were monitored weekly and half twice weekly. Researchers detected a potential trend that major events such as emergency department visits or hospital admissions were less prevalent among patients 55 and older who received high-dose vancomycin with twice-weekly TDM.
About Option Care
Option Care Enterprises, Inc. (Option Care) is the nation’s leading and most trusted provider of home and alternate site infusion services. Holding accreditations from industry quality organizations ACHC, PCAB, ASHP and URAC,[*]Accreditation Commission for Health Care (ACHC), Pharmacy Compounding Accreditation Board (PCAB), American Society of Health-System Pharmacists (ASHP) and URAC the company draws on nearly 40 years of clinical care experience to offer patient-centered therapy management. Option Care’s signature infusion services include the clinical management of infusion medicines, nursing support and care coordination. Option Care’s multidisciplinary team of more than 1,800 clinicians — including pharmacists, nurses and dietitians — are able to provide infusion service coverage for nearly all patients across the United States needing treatment for complex and chronic conditions. Learn more at www.OptionCare.com.