Those are not US usage. US home infusion is via infusion nurse and speical pharmacy for those who had been on ERT for many years without any problem:
Chronically ill patients have unique needs and often require
assistance to manage their therapies. Specialty pharmacies,
like Nova Factor, help patients by meeting their specific
needs and offering the coordination of home infusions.
Home infusions, when medically appropriate, may offer flexibility,
convenience, and privacy for patients receiving enzyme
replacement therapy (ERT). At first it may seem like there is a good
amount of work involved in setting up the home infusion process,
but once the initial coordination is done, home infusions may make
it easier on the patient and the physician. For some patients, it permits
infusions to occur in a familiar environment that increases
comfort level and does not require travel.
The decision to transition to home care is a collaborative one
between the physician, patient, and (in most cases) the insurance
company. The physician will evaluate each patient requesting home
care and work with the home care agency and pharmacy to develop
a treatment plan.
PATIENT SAFETY IS IMPORTANT
The primary concern is always the patient’s safety. The health care
providers involved in patient treatment take necessary precautions to
help ensure that the patient is an appropriate candidate for home
care, to ensure that the nurse has proper training, and to deliver the
necessary supplies so that everything needed is on hand for a successful
infusion and added peace of mind.
As a distributor partner to Genzyme, Nova Factor is a pharmacy
experienced and trained in providing comprehensive services tailored
to patients receiving Cerezyme® (imiglucerase for injection).
The process for home care begins with Nova Factor’s clinical coordinator,
who is also a registered nurse. The clinical coordinator will
credential and select a qualified and experienced home care agency
based on the patient’s geographical location, needs, and preferences.
As part of the Nova Factor credentialing process, the infusion
nurse must attend an in-service training program on ERT infusion,
dosage, proper storage, potential side effects, and proper documentation.
An educational reference manual is provided to each infusion
nurse. Upon completion of the educational session, a competency
test is required.
A pharmacist calls the patient prior to the initial visit to arrange the delivery of the medication and to validate the shipping address.
During this call, the pharmacist will discuss the delivery process, the
proper storage of the medication, and answer all questions the
patient may have about ERT. A comprehensive drug history is
obtained and documented to help ensure the safety of the patient.
The clinical coordinator calls the patient and infusion nurse to
schedule the initial visit. After the visit, the coordinator checks on
the patient and the nurse to assess satisfaction. After the initial visit,
the pharmacist will call the patient to address additional questions.
Once the initial visit has taken place the clinical coordinator monitors
the infusion nurse/patient relationship on a quarterly basis,
making adjustments as needed.
The infusion nurse documents each visit. A standardized
visit report form is submitted to the pharmacy for communication,
in part to assure timely changes to ship dates and supplies.
Prior to each shipment, Nova Factor confirms the infusion date,
doses on hand, address changes, and supply changes with the
patient and/or caregiver. It is important that the patient or caregiver
speak with a pharmacy representative before a shipment is
sent to be sure someone is at home to receive the package. The
pharmacy continues to monitor the safety and efficacy of the
therapy administered at home during regular calls to arrange
shipments.
The patient should notify the pharmacy and his or her doctor
of all changes that may affect therapy, including vacations, illnesses,
or hospitalizations. With advance notice, Nova Factor can partner
with the physician and home care agency to help prevent missed or
delayed infusions.
Flexibility of the infusion nurse, pharmacy, and the patient are
key for successful home infusions. The patient can work with the
infusion nurse to coordinate a date, time and/or place so the patient
is comfortable. And, the patient can work with the pharmacy to
coordinate ship dates and keep the pharmacy updated on changes so
infusions and treatment plans are on track.
When medically appropriate, home infusions offer patients and
physicians an opportunity to help make the management of their
therapy more convenient. With the support of the pharmacy and
other health care providers, the transition to home care can greatly
enhance the convenience of the infusion process.
