title: Evaluation and comparison of safety, convenience and cost of administering intravenous pamidronate infusions to children in the home and ambulatory care settings.
abstract: The use of bisphosphonates in children to treat low bone mineral density has increased. Safety and efficacy of pamidronate has been previously demonstrated. However, little research has been done on pamidronate infusion in the home health setting for patients with metabolic bone disease. Data were collected via a survey to assess satisfaction and convenience of infusions. Adverse events were measured by collecting calcium levels before and after infusions. Infusion costs were estimated from the standard orders from one home health agency and our infusion center. We found no difference in the rates of hypocalcemia between the two groups. The survey results showed high satisfaction for both groups, with higher scores in the home health group for convenience and stress. Home health infusions showed lower cost and less absenteeism from school and work. Home health-based pamidronate infusion appears to be safe, less expensive, and is associated with high patient satisfaction.
authors.affiliation: University of Nebraska Medical Center, Munroe-Meyer Institute for Genetics and Rehabilitation, Omaha, 68198-5440, USA. erush@unmc.edu
authors.forename: Eric T
authors.initials: ET
authors.lastname: Rush
authors.forename: Kristi
authors.initials: K
authors.lastname: DeHaai
authors.forename: Rose M
authors.initials: RM
authors.lastname: Kreikemeier
authors.forename: Richard E
authors.initials: RE
authors.lastname: Lutz
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics* / Q000592:standards; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D001851:Bone Diseases, Metabolic / Q000188:drug therapy* / Q000191:economics; D002648:Child; D003362:Cost-Benefit Analysis; D004164:Diphosphonates / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D019538:Health Care Surveys / Q000191:economics; D006699:Home Care Services / Q000191:economics* / Q000592:standards; D006801:Humans; D007262:Infusions, Intravenous / Q000191:economics / Q000592:standards; D010013:Osteogenesis Imperfecta / Q000188:drug therapy / Q000191:economics; D010024:Osteoporosis / Q000188:drug therapy / Q000191:economics; D000077268:Pamidronate; D017060:Patient Satisfaction; D015397:Program Evaluation
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate