A study by Marshall, Wong and Sahota explores the possibility of delivering an intravenous zolendronic acid at home service, and shows great results in terms of patient satisfaction and cost effectiveness.
Innovative intravenous osteoporosis at home service
Background: Intravenous bisphosphonates are an attractive alternative to oral treatments, but usually require a day-hospital or day-case admission.
Service: This service is one of the first in the country. It is based around a contractual agreement with Healthcare at Home, one of the UK’s largest home healthcare providers. The patient pathway comprises of assessment in the outpatient clinic, consent and routine blood tests. A prescription is then sent to Healthcare at Home, who administered the 1st and subsequent infusions, directly in the patient's home, within 4 weeks. A system re-call ensured appropriate follow up.
Evaluation: A telephone questionnaire was undertaken in 52 patients who had attended the day hospital the previous year for their 1st infusion and who had been referred to Healthcare at home for their 2nd infusion.
- On a scale of 1-not convenient to 5-very convenient, when asked how convenient the service was, day-hospital median score was 3 and at home service, 5.
- On rating the service 1-very poor to 5-excellent, the median score for the day hospital service was 3 and at home, 5, and given the choice 51/52 patients preferred the at home service.
- There were no reported adverse events and overall cost savings of £ 292 per patient (day hospital tariff + drug cost minus Healthcare at home service + drug cost).
Conclusion: This services offers an innovative, safe and cost-effective delivery of intravenous bisphosphonate at home. Patient preference and patient satisfaction was high. Clearly as generic intravenous zoledronic acid becomes available this year, drug delivery will become an important issue.
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