Home Infusion – It’s Safe, Effective and the Preferred Site of Care for Patients

Pharmacist Yvonne Viteri
Yvonne Viteri, PharmD, BCACP
Accredo Clinical Program Senior Advisor
Jun 08, 2023
A nurse speaks with a patient during the at-home infusion process.

Studies have shown that patients diagnosed with a chronic, complex condition would often prefer to receive treatment in the comfort of their own home. Patient preference, combined with new research demonstrating treatments like therapy infusions are safe and effective at home, suggests that the number of patients receiving treatment at home will continue to grow. In fact, home infusions are expected to grow almost 80% by 2030.

A recent Accredo study looked at 863 patients receiving maintenance doses of infliximab (Remicade®, Renflexis®, Inflectra®), a specialty medication used to treat inflammatory conditions such as rheumatoid arthritis, Crohn's disease and ulcerative colitis, through home infusion. More than 95% of patients completed home infusion safely with no adverse reaction. Of the 4.5% of patients experiencing a reaction, most were fatigue, skin-related issues and cardiopulmonary symptoms that could be managed safely by the nurse or the patient themselves in the home. Only 0.35% had a reaction that required advanced care. The manufacturer drug information suggests an adverse reaction rate of 9% with maintenance infusions, twice the rate of the patients studied under Accredo’s care. This suggests that home infusions are not only more comfortable, and often more cost-effective, but also just as safe as infusions in a hospital, infusion center or doctor’s office, especially for maintenance doses. Clinical safety and effectiveness associated with home infusion are not limited to infliximab – research also suggests patients are no more likely to experience an adverse reaction with therapies that treat other conditions like hemophilia.

The Convenience of Home Infusion

Home infusion services provide patients with quality clinical care in the convenience and comfort of their home. Patients report more independence and improved quality of life when they are able to receive treatment at home. An hour-long appointment in an infusion center or doctor’s office can easily turn into a half-day commitment with travel, pre-treatment and post-treatment and waiting in between. Home infusion patients can often carry on with daily responsibilities, interact with family, and even work from home during treatment – all with the confidence of having a dedicated nurse to care for them should additional assistance be needed.

One-on-One Clinical Care

The home infusion care model really is unique in the one-on-one attention and care provided to patients. The patient is the sole focus of their nurse for the duration of treatment – infusion centers and offices typically are not staffed to provide one-on-one attention. The nurse continuously monitors for any issues and stays with the patient until treatment is completed. They can slow or modify the infusion rate when needed. Through Accredo’s in-home nursing model, patients typically have one primary and one secondary nurse – so patients will have trusted and consistent care throughout their treatment. This model fosters a more comfortable relationship between the patient and their infusion nurse – which is one reason Accredo home infusion patients report a +97% satisfaction rate.

Additional Home Infusion Considerations

While the popularity of home infusion services continues to grow, some prescribers express concerns that infusion nurses may not have access to the support they need in the case of an adverse event. Because it is an infusion nurse’s primary job to support these types of infusions for a limited number of therapies, they are very familiar with and equipped to manage the complexities of administration for a specific therapy. Moreover, specialty pharmacies add an extra layer of safety. Prior to the first home infusion, the Accredo team works with the prescriber to make sure they are aligned on how to manage any adverse events that may occur during the infusion. Automated dispensing systems also help to minimize potential dispensing errors, and sophisticated drug utilization review tools allow specialty pharmacies to check for potential drug interactions and other utilization issues by analyzing drug history that a prescriber’s office may not see. Moreover, home infusion comes with significant savings – home infusion reimbursement rates are typically 40% to 60% lower than other outpatient settings.

Although home infusion performed by a trained nurse has been shown to be safe for many patients and medications, it should be considered on a therapy-by-therapy basis. For example, the Accredo infliximab study only looked at patients on maintenance doses of the specialty medication. Accredo follows a rigorous process to determine which medications can be safely administered in the home under specific circumstances.

Home infusion is widely accepted by patients as a preferred option for care based on the one-on-one attention and the flexibility to maintain productivity and normalcy while receiving therapy. While not all therapies are appropriate for home infusion, studies show that in many cases home infusion is safe, effective and preferred by patients. To learn more about the one-on-one clinical care provided through Accredo home infusion nursing services, contact your account representative today.

Related Articles