Home intravenous anti-infective therapy (HIVAT): do the benefits outweigh the risks?
Home intravenous anti-infective therapy (HIVAT) has become an accepted mode of treatment worldwide. There are a number of risks intrinsic to such therapy which can be reduced by a team approach, coupled with careful patient selection criteria, a structured follow-up process and an emphasis on patient education. The benefits of HIVAT include the well-being accrued as a result of being at home, the possibility of returning to work or school, and a reduced risk of infectious and intravenous (IV) cannula-related problems. From a societal standpoint, economic cost-benefit analyses provide ample evidence of cost effectiveness. Studies indicate that potential risks, such as noncompliance, interruption of therapy, drug and IV catheter-associated problems, are infrequent. In the US, reimbursement for HIVAT services for the elderly remains a problem.
Williams
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Department of Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D000075202:Contraindications; D015774:Ganciclovir / Q000627:therapeutic use; D006678:HIV / Q000187:drug effects; D018718:Home Infusion Therapy / Q000009:adverse effects / Q000191:economics / Q000523:psychology; D007262:Infusions, Intravenous / Q000009:adverse effects* / Q000191:economics / Q000523:psychology; D007349:Insurance, Health, Reimbursement / Q000191:economics; D010353:Patient Education as Topic
D000935:Antifungal Agents; D000998:Antiviral Agents; D002511:Cephalosporins; D002443:Ceftriaxone; D000666:Amphotericin B; D015774:Ganciclovir