title: Safety and cost benefit of an accelerated infliximab infusion protocol in the treatment of ambulatory patients with inflammatory bowel diseases.
abstract: BACKGROUND
  Infliximab is recommended to be infused over 2 h, but accelerated infusion rates of 30 min may improve efficiency, patient satisfaction and reduce nursing time and cost. The safety of this approach is not established. This study aims to assess the safety of accelerated infliximab infusion and determine the direct cost savings.
  
  
  METHODS
  The primary endpoint of the study was adverse events and the secondary endpoints were cost, time saving per infusion and patient satisfaction associated with an accelerated infusion protocol.
  
  
  RESULTS
  One hundred and thirty-six and 342 infusions were administered to 23 and 39 patients in the standard and accelerated protocols, respectively (mean infusion times 150 and 73.4 min, respectively, p < 0.0001). The adverse reaction rate of the standard protocol was 2.2% (95% confidence interval: 0.46 - 6.57) and accelerated protocol was 3.2% (95% CI: 1.74 - 5.73; p = 0.77). The odds ratio of adverse reaction for the 30-min infusion was 0.40 (95% CI: 0.09 - 1.82). The relative direct cost of nursing was decreased by 51.1% per infusion. Patient satisfaction score of the accelerated protocol was 9.2/10 (95% CI: 8.55 - 9.76) compared to 8.5/10 (95% CI: 7.83 - 9.17) in the initiation phase (p = 0.018).
  
  
  CONCLUSIONS
  Accelerated 30-min infliximab infusions significantly reduced nursing time, cost and increased patient satisfaction without increasing infusion reactions. Increased patient freedom and improved efficiency in healthcare delivery can be expected.
authors.affiliation: Concord Hospital, Gastroenterology and Liver Services, Sydney Local Health District , Sydney, New South Wales , Australia.
authors.forename: Payal
authors.initials: P
authors.lastname: Saxena
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.forename: Bilel
authors.initials: B
authors.lastname: Jideh
authors.forename: Glen
authors.initials: G
authors.lastname: Collins
authors.forename: Rupert W
authors.initials: RW
authors.lastname: Leong
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics* / Q000379:methods; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics*; D003362:Cost-Benefit Analysis / Q000379:methods; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000191:economics; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000191:economics*; D000069285:Infliximab; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000191:economics; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D000069285:Infliximab