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Home-based treatment with immunoglobulins: an evaluation from the perspective of patients and healthcare professionals.

Zuizewind, C.A., Kessel, P. van, Kramer, C., Muijs, M.M., Triemstra, A.H.M. Home-based treatment with immunoglobulins: an evaluation from the perspective of patients and healthcare professionals. Journal of Clinical Immunology: 2018, 38(8), 876-885
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Purpose
This study aims to evaluate home-based treatment with immunoglobulin (IgG) by assessing and comparing the experiences and perceived value of patients and healthcare professionals, and potential differences in experiences between subcutaneous (SCIg) and intravenous (IVIg) modes of administration. As choices on the location and type of treatment are determined in a shared decision-making process, we evaluated the home-based treatment from the perspectives of both patients and professionals.

Methods
A questionnaire study was conducted among 205 patients, 44 informal caregivers, 43 hospital professionals, and 21 nurses of the Sanquin Home Service (SHS) that provides home treatment with immunoglobulins in the Netherlands. Experiences, perceived benefits, and effects on the patients’ quality of life and overall ratings were assessed.

Results
Both patients and professionals were predominantly positive about the home treatment, irrespective of the administration mode. The home-based treatment with Ig contributed to the patients’ autonomy, participation, and perceived health. Patients and informal caregivers valued the treatment with a global rating of 8.84, and professionals with 8.32 (on a scale from 0 “worst” to 10 “best possible care”). SCIg and IVIg patient groups differed in their experiences regarding the accessibility and communication of the home treatment service. Furthermore, hospital professionals reported lower effects on quality of life than patients themselves.

Conclusions
Home-based treatment with immunoglobulins is highly valued because of its personalized and effective character, meeting the needs and preferences of patients. Nonetheless, patients and professionals do have different perspectives on the value of this type of care. (aut. ref.)