Background: Shorter infusions of infliximab for inflammatory bowel disease seem to be as tolerated as standard procedures and nurses may be able to manage them safely. Aims: To test tolerability and effectiveness of a fast nurse-led infusion procedure and the related patients' satisfaction. Methods: We retrospectively compared three different regimens adopted in our outpatient infusion unit from 2010 to 2013: Group 1, a standard procedure with two-hour infusions, preceded by hydrocortisone medication (87 patients, 311 infusions); Group 2, a similar regimen without physician supervision (130 patients, 464 infusions); Group 3, a one-hour nurse-led procedure without routine premedication (176 patients, 1356 infusions). Disease characteristics, infusion reactions, infusions per month and patients' satisfaction were recorded. Results: There were significantly fewer infusion reactions in Group 3 than Group 1 (2.2% versus 5.8% respectively; p = 0.001). The only significant risk factor for side effects was premedication (odds ratio 4.71, 95% confidence interval 2.21-10.02, p < 0.001) which was related to the presence of previous side effects. Number of infusions per month increased by 27% (83 versus 61, p < 0.001) without increasing nurses' workload and patients were satisfied. Conclusions: Our fast nurse-led procedure was well tolerated, effective and satisfactory for patients. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
A nurse-led accelerated procedure for infliximab infusion is well tolerated and effective in patients with inflammatory bowel disease
MICHIELAN, ANDREA;CACCARO, ROBERTA;CARUSO, ANTONINO;STURNIOLO, GIACOMO;
2015
Abstract
Background: Shorter infusions of infliximab for inflammatory bowel disease seem to be as tolerated as standard procedures and nurses may be able to manage them safely. Aims: To test tolerability and effectiveness of a fast nurse-led infusion procedure and the related patients' satisfaction. Methods: We retrospectively compared three different regimens adopted in our outpatient infusion unit from 2010 to 2013: Group 1, a standard procedure with two-hour infusions, preceded by hydrocortisone medication (87 patients, 311 infusions); Group 2, a similar regimen without physician supervision (130 patients, 464 infusions); Group 3, a one-hour nurse-led procedure without routine premedication (176 patients, 1356 infusions). Disease characteristics, infusion reactions, infusions per month and patients' satisfaction were recorded. Results: There were significantly fewer infusion reactions in Group 3 than Group 1 (2.2% versus 5.8% respectively; p = 0.001). The only significant risk factor for side effects was premedication (odds ratio 4.71, 95% confidence interval 2.21-10.02, p < 0.001) which was related to the presence of previous side effects. Number of infusions per month increased by 27% (83 versus 61, p < 0.001) without increasing nurses' workload and patients were satisfied. Conclusions: Our fast nurse-led procedure was well tolerated, effective and satisfactory for patients. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
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