Home treatment with IV antibiotics could relieve NHS pressure

(Press-News.org) Treating patients at home with IV antibiotics, rather than in a clinical setting, could halve costs to the NHS and relieve pressure on hospital beds – according to a University of East Anglia study.

Researchers investigated whether having antibiotics prepared at home and continuously delivered into the bloodstream by an elastomeric pump would be a viable option.

They found that both patients and clinicians were happy with this method, and that it could save the NHS more than £3,500 per patient.

If rolled out nationally, the team say it could save the NHS millions and free-up vital hospital beds.

Lead researcher Dr Stephanie Howard Wilsher, from UEA’s Norwich Medical School, said: “Pressure on hospital beds is a longstanding issue for the NHS, which calls for innovative solutions.

“We wanted to see whether treating people at home with IV antibiotics would be both acceptable for patients and clinicians - and importantly, cost-saving.”

Elastomeric pumps are small, single use devices used to administer medication such as intravenous (IV) antibiotics.

Recent advances allow medication to be mixed, and the device filled, at home - rather than being prepared by a pharmacy.

Dr Howard Wilsher said: “Using these pumps at home has the potential to relieve pressure on hospital beds, and facilitate earlier discharge for patients, or allow them to remain at home and avoid a hospital stay altogether.

“We asked patients, carers and clinicians for their views on using the pump at home, and we assessed the costs of this against the cost of staying in hospital, going to an outpatient clinic, or using a pump at home that had already been filled by a pharmacist.”

A total of 24 patients were recruited and medication was prepared and administered at their homes by trained nurses and delivered by the elastomeric pump over 24 hours. Patients were monitored remotely twice daily.

The pump tested was a B. Braun EasyPump® II elastomeric device, with support from Doccla - a company founded to provide Virtual Wards to support the NHS, enabling patients to be safely monitored at home using connected medical devices and digital technology.   

The team found that both patients and clinicians were happy with the home treatment, and that it would make vital cost savings for the NHS.

The per-patient cost of nurse-filled at-home treatment was £2,507.54 - significantly lower than staying in hospital (£6,122.70), daily visit to an outpatient clinic (£3,603.76), or using a pre-filled pump at home (£4,373.37).

“Overall, patients, carers, and clinicians were pleased with medication being prepared and administered at home using the elastomeric pump,” said Dr Howard Wilsher.

“Using the device at home provides greater independence for patients, while reducing pressure on hospital beds and providing good healthcare at much needed cost-savings for the NHS.”

“Although the evaluation was based on a small sample size, our findings suggest that treatment at home could be economically and realistically feasible to help the NHS meet growing demand for high-quality care.”

This research was led by the University of East Anglia, in collaboration with the University of Cambridge, Imperial College London, HealthWatch Hertfordshire, Hertfordshire Community NHS Trust, and Health Innovation East.

It was funded by Health Innovation East.

‘Elastomeric devices in Hertfordshire: A mixed methods evaluation’ is published in the Journal of Clinical Pharmacy and Therapeutics.

 

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