title: Intravenous enzyme replacement therapy: better in home or hospital?
abstract: This article evaluates satisfaction with enzyme replacement therapy (ERT) at home and at hospital in adult patients with Fabry and Gaucher diseases. A questionnaire was developed and sent to 34 patients with Fabry disease who were receiving ERT with agalsidase alfa (Replagal) and to 49 patients with type I Gaucher disease who were receiving ERT with glucocerebrosidase (Cerezyme). Of the 45 returned questionnaires, 20 were from patients with Fabry disease and 25 from patients with Gaucher disease. Hospital treatment visits were reported as stressful by 18 patients (40%), whereas only 4 (9%) patients reported that home therapy was stressful. Both groups of patients adjusted well to receiving home-based therapy. Nearly all of the patients with Fabry disease (19 patients, 95%) and Gaucher disease (21 patients, 84%) preferred home-based therapy. Treatment in the home was reported as more comfortable, less stressful, more effective and had less impact on family life. Only 4 (9%) patients chose to continue receiving infusions in hospital. The majority of patients with Fabry disease and Gaucher disease found home-based therapy to be more convenient and less stressful than hospital-based therapy.
authors.affiliation: Lysosomal Storage Disorders Unit, Royal Free Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Milligan
authors.forename: D
authors.initials: D
authors.lastname: Hughes
authors.forename: S
authors.initials: S
authors.lastname: Goodwin
authors.forename: L
authors.initials: L
authors.lastname: Richfield
authors.forename: A
authors.initials: A
authors.lastname: Mehta
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D000795:Fabry Disease / Q000188:drug therapy / Q000451:nursing / Q000523:psychology*; D005192:Family Health; D005776:Gaucher Disease / Q000188:drug therapy / Q000451:nursing / Q000523:psychology*; D005962:Glucosylceramidase / Q000627:therapeutic use; D018718:Home Infusion Therapy / Q000451:nursing / Q000523:psychology*; D006801:Humans; D007262:Infusions, Intravenous; D007297:Inpatients / Q000523:psychology*; D007527:Isoenzymes / Q000627:therapeutic use; D008875:Middle Aged; D024802:Nurse's Role; D015404:Nursing Methodology Research; D017060:Patient Satisfaction; D011788:Quality of Life; D035583:Rare Diseases; D011994:Recombinant Proteins; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D000519:alpha-Galactosidase / Q000627:therapeutic use
chemical_list: D007527:Isoenzymes; D011994:Recombinant Proteins; C000627036:agalsidase alfa; D000519:alpha-Galactosidase; D005962:Glucosylceramidase