Education of patients with primary

hypogammaglobulinemia for S/C Ig self-administration

The Saint-Louis Hospital (Paris) Experience

R. Laumond, J. Baron Lysio, M-L Doizé

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

The educational booklet

Evaluation scaleHygiene and installation

Week 1, 2, …

Technical care

Hand washing, AsepsisWastePeremption of products…

Date, and validation:-Demonstration-Made « alone or with »-Acquired

Inclusion S/C administration of Ig is a medical decision

Eligibility Criteria : Voluntary contribution Cognitive capacity Subjective assessment of skilfulness Rule approval

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

Practical course

Hand washing Work surface organization Syringe manipulation

Programming and connecting the ambulatory infusion pump

Draining the tubulure after adjusting it on the syringe

Decontamination of the cutaneous surface

Installation and occupation of the patient during infusion as wished

Subcutaneous injection

Made alone

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

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

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

Conclusion