Can patients schedule own treatment with infliximab (IFX)? A nurse quality control project

Anne Berg, Jens Kjeldsen

Research output: Contribution to journalConference abstract in journalResearchpeer-review

Abstract

Background
Patients receiving IFX treatment often have to leave work/school in order to be treated in the morning. This may be inconvenient for the patients and give capacity problems for the infusion unit at the out-patient clinic. The aim of the study was to investigate if patient-controlled timing of treatment with IFX, within a treatment window, affects patient satisfaction and is safe.

Methods
Patients with IBD in stable treatment with IFX were offered inclusion in this quality control project. Inclusion criteria were: clinical remission (for Crohn’s disease (CD) a Harvey Bradhsaw score ≤5 and for ulcerative colitis (UC) a SCCAI score ≤4); who received treatment at 6–10 week intervals, had received more than 10 treatments and were expected to continue with treatment for a minimum of 6 months. The study period was 1 year. In this period patients scheduled their treatment within a 3 week window around a scheduled treatment day. It was possible for the patient to meet in the out-patient clinic two days a week between 14:00 and 15:00 without prior arrangement. Patient satisfaction (questionnaire at end of project) and patient compliance was measured.

Results
30 patients (males/females: 14/16) between 18–72 years (median age of 38 years) were included. 20 had CD and 10 had UC. 24 patients completed the project. In the study period a total of 188 treatments with IFX were administered over 106 treatment days in the out-patient clinic, with an average of 1.8 treatments per day (range: 0 to 6 treatments per day). In 24 visits patients advanced the time for infusion of IFX compared with the scheduled visit. In 63 visits patients postponed the time for infusion compared with the scheduled visit. At 101 patient visits IFX treatment were administered in the planned treatment week. One patient had to be contacted as he exceeded the window for IFX. No acute situations occurred that required medical assistance. No correlation between increased disease activity and delayed visits were found. Twenty-seven patients fulfilled questionnaires at study end. All repliers expressed satisfaction (score 9.7/10) with the project and wanted to continue under the same conditions. In particular, patients were satisfied with the flexibility of choosing a day of treatment.

Conclusions
Within the limits for treatment planned in the study, it seems to be safe to let the patient decide the specific time for infusion of IFX. Patients are happy to have flexibility with regard to treatment day. 53.7% of IFX infusions were administered in the scheduled week, 33.5% infusions were postponed, and 12.8% of IFX treatments were advanced compared with the scheduled week of treatment. Patient postponing the visit did not experience increase in disease activity.
Original languageEnglish
Article numberN003
JournalJournal of Crohn's and Colitis
Volume12
Issue numberSuppl. 1
Pages (from-to)S569
Number of pages1
ISSN1873-9946
DOIs
Publication statusPublished - 1. Feb 2018
Event13th Congress of the European Crohn’s and Colitis Organisation - Vienna, Austria
Duration: 14. Feb 201817. Feb 2018
Conference number: 13

Conference

Conference13th Congress of the European Crohn’s and Colitis Organisation
Number13
Country/TerritoryAustria
CityVienna
Period14/02/201817/02/2018

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