People with bleeding disorders often require regular intravenous infusions of clotting factor to prevent or treat bleeding episodes in the home.
Although the ideal method of infusions is through peripheral IV access, some patients – especially those who need frequent treatments – may require a central venous access device (CVAD), which is a permanent portal implanted in a vein. However, a CVAD carries the risk for central venous line infections, which can cause potentially life-threatening complications. These infections are the most common cause of hospitalization in children with hemophilia.
Understanding the Rate of Infection
A meta-analysis of multiple studies found the rate of central venous line (CVL) infection among patients with hemophilia – across a number of infusion settings including doctor’s offices and outpatient hospital – was 0.66 per 1,000 CVAD days.
Accredo researchers sought to understand the rate of CVL infections among patients receiving treatment through Accredo home healthcare services. We monitored 777 patients receiving in-home treatment over the course of five years – the largest sample size published to date. The study included patients with hemophilia A, hemophilia B, von Willebrand disease and other coagulation defects. The cumulative rate of infection for these patients was 0.19 per 1,000 CVAD days, which is 71% lower than in the meta-analysis.
The Value of Home Infusion
Not only has home infusion proven to be a safe option for patients, it is also less expensive for plan sponsors due to avoided medical costs. It is estimated that the cost of a central venous line infection can cost more than $29,000 per episode.
At Accredo, we have more than 550 field nurses who visit patients – at home, work or school – to administer specialty medications for some of the most complex disease states, like bleeding disorders. Additionally, 63% of field nurses have pediatric experience. Their extensive infusion experience and in-depth knowledge of complex disease states provide the basis for extensive care coordination necessary to treat these patients.
Safe, Convenient Care
Infusion by CVAD is an important option for patients with bleeding disorders and requires strict attention to sterile technique. With an overall lower rate of infection, infusions can be managed safely in the homecare setting.
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