The Feasibility of Self-administration of Subcutaneous Immunoglobulin in a Diverse Patient Population

Abstract

RATIONALE: The method of delivery of many biologics and efforts by managed care providers to control healthcare costs are driving the growth in drug self-administration, particularly for chronic conditions. This analysis was conducted to assess the feasibility of self-administration of subcutaneous immunoglobulin in a diverse patient population.METHODS: A retrospective chart review, of a national infusion provider, was conducted on 145 demographically diverse patients treated throughout the U.S. Data was analyzed to determine key demographics, adverse effects, patient satisfaction/retention and time to administration independence.RESULTS: Patients were aged from 0-6 (10.3%), 7-16 (19.3%), 17-49 (40.7%) and ≥ 50 (29.6%). The mean number of total infusions reported prior to the day of audit was 78.6 (range 1 to 750). 45 patients (31.03%) reported a total of 49 adverse events (1 (2%) was severe). The most common AEs were site irritation (53.3%) and site swelling (24.4%). 14 patients (9.6%) returned to intravenous administration (42.8% due to patient preference). 75.86% were recorded as independent with self-administration, 81.8% in < three days/doses. Of patients not independent, 75% were > 50 years. The data reveal a widely diverse patient group, low incidence of severe adverse effects, infrequent switch to intravenous administration and a rapid time to independent self-administration for most patients.CONCLUSION: Patients with complex diseases may be required or choose to self-manage therapy administration, regardless of demographic characteristics. This study suggests that for many patients, with effective support, independent self-infusion of subcutaneous immunoglobulin is possible in a non-traditional setting. RATIONALE: The method of delivery of many biologics and efforts by managed care providers to control healthcare costs are driving the growth in drug self-administration, particularly for chronic conditions. This analysis was conducted to assess the feasibility of self-administration of subcutaneous immunoglobulin in a diverse patient population. METHODS: A retrospective chart review, of a national infusion provider, was conducted on 145 demographically diverse patients treated throughout the U.S. Data was analyzed to determine key demographics, adverse effects, patient satisfaction/retention and time to administration independence. RESULTS: Patients were aged from 0-6 (10.3%), 7-16 (19.3%), 17-49 (40.7%) and ≥ 50 (29.6%). The mean number of total infusions reported prior to the day of audit was 78.6 (range 1 to 750). 45 patients (31.03%) reported a total of 49 adverse events (1 (2%) was severe). The most common AEs were site irritation (53.3%) and site swelling (24.4%). 14 patients (9.6%) returned to intravenous administration (42.8% due to patient preference). 75.86% were recorded as independent with self-administration, 81.8% in < three days/doses. Of patients not independent, 75% were > 50 years. The data reveal a widely diverse patient group, low incidence of severe adverse effects, infrequent switch to intravenous administration and a rapid time to independent self-administration for most patients. CONCLUSION: Patients with complex diseases may be required or choose to self-manage therapy administration, regardless of demographic characteristics. This study suggests that for many patients, with effective support, independent self-infusion of subcutaneous immunoglobulin is possible in a non-traditional setting.