Name of the Procedure

Home Infusion Therapy, Uninterrupted, Long-Term, Controlled Rate Intravenous or Subcutaneous Infusion Therapy (e.g., Epoprostenol); Administrative Services, Professional Pharmacy Services, Care Coordination, and All Necessary Supplies and Equipment (HCPCS Code: S9347)

Summary

Home infusion therapy is a medical treatment where medication (such as epoprostenol) is administered continuously through a controlled rate intravenous (IV) or subcutaneous (under the skin) infusion. This is performed at a patient's home, and it includes all necessary supplies, equipment, and professional services for safe and effective administration.

Purpose

Home infusion therapy is used to treat chronic medical conditions that require long-term medication delivery. The primary goal is to manage symptoms and improve the patient's quality of life while allowing them to remain in the comfort of their home.

Indications

• Chronic heart failure
• Pulmonary arterial hypertension
• Severe chronic respiratory conditions
• Conditions requiring continuous medication delivery due to short half-life of the drug

Preparation

• Ensure all necessary equipment and medications are delivered to the home.
• Instructions on safe medication storage.
• Training on infusion pump use and aseptic techniques.
• Pre-treatment labs or diagnostic tests as determined by the healthcare provider.

Procedure Description

1. Medication and equipment delivery: Medication, along with the infusion pump, tubing, and other supplies, are delivered to the patient’s home.
2. Setup: A healthcare professional sets up the infusion pump and demonstrates its use. They ensure the patient or a caregiver is comfortable operating the device.
3. IV or subcutaneous insertion: An intravenous catheter or subcutaneous needle is placed.
4. Infusion initiation: The infusion is started at a controlled rate using the infusion pump.
5. Monitoring: Regular monitoring and coordination by healthcare professionals to manage dosing, check for complications, and order additional supplies.

Duration

This therapy is long-term and often continuous. The duration is specific to the patient’s condition and treatment plan.

Setting

Performed in the patient's home under the coordination of healthcare professionals.

Personnel

• Home infusion nurse
• Pharmacist
• Care coordinator
• Primary healthcare provider

Risks and Complications

• Infection at the catheter or needle site
• Mechanical complications with the infusion pump
• Adverse drug reactions
• Risk of catheter displacement or blockage
• Monitoring and managing side effects from the medication

Benefits

• Ability to receive essential medication without frequent hospital visits.
• Improved comfort and quality of life.
• Effective management of chronic conditions.

Recovery

• Continuous therapy with regular follow-up appointments.
• Adherence to specific hygiene and maintenance protocols to prevent infection.
• Possible lifestyle adjustments and ongoing monitoring.

Alternatives

• Hospital-based continuous infusion therapy.
• Oral or alternative medication forms where applicable.
• Consideration of the invasiveness, cost, and convenience of each alternative.

Patient Experience

Patients may initially feel apprehensive about the equipment and process but often gain confidence with training and support. They may experience site discomfort, which can be managed with proper care. Regular communication with healthcare providers ensures support and timely management of any issues.