JLE

Journal de Pharmacie Clinique

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Outpatient dispensation of subcutaneous immunoglobulins: who is concerned? What is the follow-up? Volume 27, issue 1, janvier-février-mars 2008

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Authors
Service de pharmacie, Hôpital Saint-Louis, Paris

The marketing authorisation of subcutaneous immunoglobulins in 2005 increased the outpatient dispensation of Saint-Louis hospital with the dispensation of plasma products. With the important development of this activity, an evaluation of the patient treatment at home was performed. The software used to manage plasma products and patient follow-up allowed to collect data relative to the treatment by immunoglobulins (administrations, infection, local and general tolerance) for all patients receiving an administration of Ig in 2006. 63 patients were studied during a 8 months period. 75% were treated by Tégéline ®, 16% have had Gammagard ® treatment and 9% Endobuline ® treatment. The initiation of subcutaneous treatment was performed for 71% of the patients at the hospital with an average of 3 sessions. 44 patients received Subcuvia ®, 19 Gammanorm ®. Out of 7877 delivered drug units, administration of 58% was recorded at home. The patient follow-up forms were returned by 34 patients: mainly 2 injection sites (64%) on the belly (53%) permitted the self infusion at home (85%). Upper respiratory tract infections between two injections were reported by 76,4% of the patients. Local and general effects respectively concerned patients under Gammanorm ® (60% and 60%) and under Subcuvia ® (17% and 13%). 55 % of patients were helped at home by a provider of service and the tracability of their injections was 58% as all groups. The subcutaneous infusion improves the quality of life of patients with Ig treatment, but the home follow-up was insufficient. The pharmacist must have an implication in this activity to improve quality of home’s care and optimize recording adverse effect and injection tracability: meeting with providers of service, improvement of follow-up dispensation and patient information.