Safety and patient experience with at-home infusion of ocrelizumab for multiple sclerosis.

OBJECTIVE: This study aimed to evaluate safety (infusion-related reactions [IRRs]) and patient satisfaction (patient-reported outcomes [PROs]) for at-home ocrelizumab administration for patients with multiple sclerosis (MS). METHODS: This open-label study included adult patients with an MS diagnosis who had completed a ≥ 600-mg ocrelizumab dose, had a patient-determined disease steps score of 0 to 6 and had completed PROs. Eligible patients received a 600-mg ocrelizumab home-based infusion over 2 h, followed by 24-h and 2-week post-infusion follow-up calls. IRRs and adverse events (AEs) were documented during infusions and follow-up calls. PROs were completed before and 2 weeks post infusion. RESULTS: Overall, 99 of 100 expected patients were included (mean [SD] age, 42.3 [7.7] years; 72.7% female; 91.9% White). The mean (SD) infusion time was 2.5 (0.6) hours, and 75.8% of patients completed their ocrelizumab infusion between 2 to 2.5 h. The IRR incidence rate was 25.3% (95% CI: 16.7%, 33.8%)-similar to other shorter ocrelizumab infusion studies-and all AEs were mild/moderate. In total, 66.7% of patients experienced AEs, including itch, fatigue, and grogginess. Patients reported significantly increased satisfaction with the at-home infusion process and confidence in the care provided. Patients also reported a significant preference for at-home infusion compared with prior infusion center experiences. INTERPRETATION: IRRs and AEs occurred at acceptable rates during in-home infusions of ocrelizumab over a shorter infusion time. Patients reported increased confidence and comfort with the home infusion process. Findings from this study provide evidence of the safety and feasibility of home-based ocrelizumab infusion over a shorter infusion period.

Education methods and techniques for training home parenteral nutrition patients.

The goal of home infusion therapy education is to teach patients and their caregivers all aspects of home infusion to ensure independence in therapy administration and to decrease vascular access device complications and long-term parenteral nutrition (PN) complications. When patients receive home PN (HPN), the education is generally more complicated and requires a focus different from routine intravenous medication infusion. In addition, the management of an HPN patient is different from a hospitalized PN patient because needs and goals of HPN patients vary from those of hospitalized patients. Educating HPN patients so that goals and outcomes can be achieved effectively while allowing the patient to maintain as independent as possible and reduce PN complications is a challenge. This article reviews the methods of education currently available to HPN patients. The education provided to HPN patients also is reviewed, with an emphasis on achieving independence and reducing PN complications.

Management of the home parenteral nutrition patient.

Parenteral nutrition (PN) support can be managed in the home setting for both a short-term and long-term period or for a lifetime, permitting individuals who cannot adequately absorb nutrients enterally to achieve a normal lifestyle. Nutrition support professionals must be aware of home PN (HPN) management principles before discharge to ensure a smooth transition to home with all requisite monitoring. This article will discuss the initiation and monitoring of patients on HPN, the prevention and treatment of potential complications, the contributions of the home infusion provider, and the home nutrition support team and the outcomes of HPN.