Home Infusions of Infliximab for Inflammatory Bowel DiseaseHome Infusions of Infliximab for Inflammatory Bowel Disease https://pediatricsnationwide.org/wp-content/uploads/2021/10/161176450-1024x683.jpg 1024 683 Mary Bates, PhD Mary Bates, PhD https://secure.gravatar.com/avatar/c6233ca2b7754ab7c4c820e14eb518c8?s=96&d=mm&r=g
- August 02, 2023
- Mary Bates, PhD
With a standardized care approach, home infusions may be an effective alternative to hospital-based infusions.
Pediatric inflammatory bowel disease (IBD) is often treated with infusions of infliximab in a hospital setting. However, these can be costly and present time and travel barriers to patients and their families. Due to these considerations and recent insurance mandates, home-based infusions of infliximab are becoming more common. Yet, their safety and effectiveness have not been adequately investigated in children.
In a new study, researchers from Nationwide Children’s compared adverse outcomes in children with IBD who received home infusions to those in children who received hospital-based infusions. This research study was initiated in conjunction with a quality improvement (QI) program to pursue a standardized care approach, says Jennifer L. Dotson, MD, MPH, co-director of the Center for Pediatric and Adolescent Inflammatory Bowel Disease at Nationwide Children’s and senior author of the study.
“Initially, we didn’t have home infusion protocols in place, and we wanted to make sure that we did this in a safe way,” she says. “I think part of the reason that we’ve had success with this is that we started by looking at it through a quality improvement lens.”
Dr. Dotson and colleagues conducted a retrospective chart review of pediatric patients at Nationwide Children’s receiving either home- or hospital-based infliximab infusions. They found that drug durability and adverse outcomes were similar in the two groups. And while children receiving home infusions had labs obtained less frequently (expected given process change), their lab values did not differ from those of children receiving hospital-based infusions.
Importantly, infusions were performed by a select group of home infusion companies (including Nationwide Children’s Homecare) under a standardized set of policies and procedures with experienced pediatric nurses.
“Our approach involves careful monitoring of patients and frequent communication between providers and families,” says Dr. Dotson, who is also an associate professor of clinical pediatrics at The Ohio State University College of Medicine. “The results suggest that home infusions are as effective as hospital-based infusions for children with IBD if a standardized approach is used.”
Up to a third of patients with IBD receiving infliximab infusions at Nationwide Children’s receive home-based infusions, according to Dr. Dotson. She says that their center’s early adoption of a standardized care approach has helped them lead the way and influence other centers with similar patients.
“We were at the forefront of putting these processes in place and working out the kinks. Now, many of our colleagues at other institutions are referring to us and our practices,” she says. “We hope that this study, which provides data on how our group does home infusions, can be a resource for other centers looking to increase the use of home-based infliximab infusions.”
Gupta SR, Bricker J, Boyle BM, Maltz RM, Michel HK, Dotson JL. Outcomes for standardized home and hospital-based infusions of infliximab for children with inflammatory bowel disease. Journal of Pediatric Gastroenterology & Nutrition. 2023 Jun 1;76(6):776-781. doi: 10.1097/MPG.0000000000003772. Epub 2023 Mar 16.