By: Option Care
July 12, 2017
Patients Benefitted Significantly Overall, According to Results
Presented at NHIA Meeting
BANNOCKBURN, Ill., July 12, 2017 — Advanced heart failure patients who receive home infusion of inotropic therapy benefit from improved quality of life, according to Option Care research presented at the 2017 National Home Infusion Association (NHIA) Annual Conference & Exposition.
Patients with advanced heart failure are prescribed intravenous (IV) inotropic therapy to help their hearts pump more efficiently while they await a heart transplant or mechanical circulatory support (MCS) or to help them spend their remaining days in greater comfort. Studies have shown inotropic therapy provided in the hospital or healthcare facility is effective, but there’s been limited research on home infusion of the treatment.
“Our study shows home inotropic therapy improved quality of life in advanced heart failure patients,”[*]Walther K, Artig-Brown T, et al. The impact of home infusion on quality of life in patients with heart failure receiving home inotropic therapy based on the Minnesota Living With Heart Failure Questionnaire. Poster presented at the 2017 National Home Infusion Association (NHIA) Annual Conference & Exposition: May 22-25, 2017; Orlando. said Kyle Walther, PharmD, lead author of the study and Option Care pharmacy resident. “Because inotropic therapy typically is provided long-term, it’s invaluable that patients have the opportunity to receive this vital care in the comfort of their own homes, so they can continue to spend time with their families and enjoy the best quality of life.”
The study included 88 adult heart failure patients who filled out the Minnesota Living with Heart Failure Questionnaire (MLHFQ) before the start of inotropic infusion and three months after home infusion of the therapy.[*]Walther K, Artig-Brown T, et al. The impact of home infusion on quality of life in patients with heart failure receiving home inotropic therapy based on the Minnesota Living With Heart Failure Questionnaire. Poster presented at the 2017 National Home Infusion Association (NHIA) Annual Conference & Exposition: May 22-25, 2017; Orlando. The MLHFQ measures the effect of heart failure on quality of life by asking patients 21 questions on issues ranging from shortness of breath to medical costs. A lower score indicates heart failure has less of an effect on the patient’s quality of life. Comparing MLHFQ results at the beginning of therapy to those after three months of therapy, researchers found that overall, there was an 8.65 percent improvement in scores among all patients, which was statistically significant. The MLHFQ scores showed home infusion of inotropic therapy was especially beneficial in reducing shortness of breath (17.13 percent improvement), hospital stays (17.65 percent improvement) and medical care cost (20.78 percent improvement).
Patients in the study received one of three types of inotropic medications: milrinone, dobutamine or dopamine. The medication was infused continuously 24 hours a day through an IV inserted in the chest or arm and stored in a small bag or fanny pack, allowing patients to be mobile. The medication was delivered to the home, and a home infusion nurse visited weekly to check the patient’s vitals, blood and infusion site and ensure the equipment was working effectively. Patients had 24/7 telephone access to pharmacists and nurses if they had questions or concerns. This high-touch care allows patients to receive help quickly, without having to wait for a response from their primary care provider or make a trip to the emergency room.
Home infusion is safe, effective and often less costly than inpatient care. For example, high-touch home infusion of inotropic medication featuring consistent clinical monitoring and support significantly reduces hospital admission rates, saving more than $17,000 per patient per year, according to Option Care research.[*]Meaux N. and Tatiel M. Hospital admission reductions among Stage D heart failure patients participating in a home inotropic infusion program. Poster presented at 7th Annual Meeting of the American Association of Heart Failure Nurses (AAHFN): June 23-25, 2011; Seattle. However, an unintended consequence of the 21st Century Cures Act, passed by the U.S. Congress and signed into law in December 2016, is the creation of a gap in Medicare coverage for home infusion of inotropic therapy, effectively taking away funding for patient access to high quality home infusion.
“Medicare pays for the care involved in providing infusion of inotropic therapy, but only if it’s provided in a hospital, nursing home or other health facility,” said Tess Artig-Brown BSN, MN, co-author of the poster and director of Option Care’s Heart Failure Program. “Few patients would choose to be in a facility receiving their care when they can be in their own homes, and our research suggests home infusion of inotropic therapy allows them to do that. Hopefully this will help draw attention to the benefits of improving patient access to high-quality home infusion.”
About Option Care
Option Care Enterprises, Inc. (Option Care) is one of the nation’s largest and most trusted providers of home and alternate treatment site infusion services. An industry leader, the company draws on nearly 40 years of clinical care experience to offer patient-centered therapy management. Option Care’s signature Home Infusion Plus 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 home infusion service coverage for nearly all patients across the United States needing treatment for complex and chronic conditions. Learn more at www.OptionCare.com.
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