Name of the Procedure:

Home Infusion Therapy, Anti-Tumor Necrosis Factor (e.g., Infliximab)

• Common Name: Home Infliximab Infusion
• Medical Term: Anti-Tumor Necrosis Factor Intravenous Therapy

Summary

Home infusion therapy involves administering medication directly into the bloodstream at home. Specifically, this treatment uses anti-tumor necrosis factor (TNF) agents like infliximab to reduce inflammation. While the medication and nursing visits are coded separately, this procedure includes all the associated administrative services, pharmacy services, care coordination, and necessary supplies and equipment.

Purpose

The purpose of home infusion therapy with anti-TNF agents is to manage chronic inflammatory conditions such as rheumatoid arthritis, Crohn's disease, and ulcerative colitis. By reducing inflammation, the treatment aims to relieve symptoms, maintain remission, and improve the quality of life.

Indications

• Conditions: Rheumatoid arthritis, Crohn's disease, ulcerative colitis, ankylosing spondylitis, psoriasis.
• Symptoms: Persistent joint pain, gastrointestinal symptoms (such as diarrhea and abdominal pain), chronic inflammation.
• Patient Criteria: Individuals who have not responded to conventional therapies or require maintenance therapy to prevent disease flare-ups.

Preparation

• Pre-Procedure Instructions: No specific fasting required. Patients should remain hydrated and follow instructions regarding any ongoing medication.
• Diagnostic Tests: Blood tests to check for infections, liver function tests, and a skin test for tuberculosis are common prerequisites.

Procedure Description

1. Initial Assessment: A nurse or healthcare professional assesses the patient's health status.
2. Preparation of Materials: Necessary supplies, like the infusion pump, IV line, and infliximab, are assembled.
3. IV Insertion: An IV line is placed into the patient's vein.
4. Medication Administration: The infliximab is infused slowly through the IV line, typically over 1-3 hours.
5. Monitoring: The nurse monitors the patient’s vital signs and any adverse reactions during and shortly after the infusion.

Duration

The infusion typically takes 1-3 hours to complete.

Setting

Home setting (Home healthcare services).

Personnel

• Registered Nurses (RNs) specialized in infusion therapy.
• Pharmacists for medication preparation and management.
• Care coordinators to manage schedule and supplies.

Risks and Complications

• Common Risks: Infusion reactions like headache, fever, chills, and rash.
• Rare Risks: Severe allergic reactions, infections, reactivation of latent tuberculosis.
• Management: Immediate treatment with antihistamines or corticosteroids for mild reactions; emergency medical care for severe reactions.

Benefits

• Reduced need for hospital visits.
• Convenience of receiving therapy at home.
• Prompt symptom relief typically noticed within days to weeks.
• Sustained disease control and prevention of flare-ups.

Recovery

• Post-Procedure Care: Patient may feel tired and is advised to rest for the remainder of the day.
• Expected Recovery Time: Generally, no extended recovery period is necessary.
• Follow-Up: Regular monitoring through healthcare visits or telehealth to assess treatment efficacy and side effects.

Alternatives

• Oral Medications: Often less effective for severe cases but easier to administer.
• Subcutaneous Injections: Self-administered but might not be as effective or suitable for all patients.
• Other Biologic Agents: Different mechanisms of action and side-effect profiles.
• Pros and Cons: Home infusion draws management of severe symptoms in a convenient setting but requires careful oversight; alternatives might be less invasive but potentially less effective.

Patient Experience

During the procedure, patients might feel a mild discomfort when the IV is inserted. Throughout the infusion, they comfortably rest at home, often with family members nearby. Post-infusion, they might experience mild side effects like fatigue or mild headaches, generally managed with rest and hydration.