Education of patients with primary hypogammaglobulinemia for SC Ig selfadministration The SaintLouis

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Education of patients with primary
hypogammaglobulinemia for S/C Ig
self-administrationThe Saint-Louis Hospital
(Paris) Experience
R. Laumond, J. Baron Lysio, M-L Doizé
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Aims of the approach

• Allowing for autonomy of patients at home
• Reducing the costs for the health system
• Modifying the use of out-patient hospital

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The educational booklet
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Evaluation scale
Week 1, 2,
Hygiene and installation
Hand washing, Asepsis Waste Peremption of
products
Technical care
Date, and validation -Demonstration -Made
 alone or with  -Acquired
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Inclusion

• S/C administration of Ig is a medical decision
• Eligibility Criteria
• Voluntary contribution
• Cognitive capacity
• Subjective assessment of skilfulness
• Rule approval

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Training period

• 3 steps for each patient
• Demonstration (showing handling by a nurse)
• Made  with  (handling with a nurse)
• Made  alone  (validated by a nurse)
• The step made  alone  can be carried on for
  several weeks until autonomy is reached

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Practical course
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• Hand washing
• Work surface organization
• Syringe manipulation

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Programming and connecting the ambulatory
infusion pump

• Draining the tubulure after adjusting it on the
  syringe

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Decontamination of the cutaneous surface
Made alone

• Subcutaneous injection

• Installation and occupation of the patient during
  infusion as wished

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Following at home

• Control session planned 3 months later in
  out-patient hospitalisation
• Thereafter, hospitalisation or consultation every
  6 months
• Call center for questions or emergency

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Quantitative Results

• 48/58 substituted patients included
• 159 out-patient sessions (Median 3 per patient)
• 1 failure (patient decision)
• Few side effects (only local reactions)
• Treatment could be resumed in all patients

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Qualitative results

• Most patients (95) were satisfied with Ig s/c
  administration
• More comfortable and painless than Ig IV
• Less time consuming
• Satisfied with the process

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Conclusion