title: A nurse-led accelerated procedure for infliximab infusion is well tolerated and effective in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Shorter infusions of infliximab for inflammatory bowel disease seem to be as tolerated as standard procedures and nurses may be able to manage them safely.
  
  
  OBJECTIVE
  To test tolerability and effectiveness of a fast nurse-led infusion procedure and the related patients' satisfaction.
  
  
  METHODS
  We retrospectively compared three different regimens adopted in our outpatient infusion unit from 2010 to 2013: Group 1, a standard procedure with two-hour infusions, preceded by hydrocortisone medication (87 patients, 311 infusions); Group 2, a similar regimen without physician supervision (130 patients, 464 infusions); Group 3, a one-hour nurse-led procedure without routine premedication (176 patients, 1356 infusions). Disease characteristics, infusion reactions, infusions per month and patients' satisfaction were recorded.
  
  
  RESULTS
  There were significantly fewer infusion reactions in Group 3 than Group 1 (2.2% versus 5.8% respectively; p=0.001). The only significant risk factor for side effects was premedication (odds ratio 4.71, 95% confidence interval 2.21-10.02, p<0.001) which was related to the presence of previous side effects. Number of infusions per month increased by 27% (83 versus 61, p<0.001) without increasing nurses' workload and patients were satisfied.
  
  
  CONCLUSIONS
  Our fast nurse-led procedure was well tolerated, effective and satisfactory for patients.
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy. Electronic address: andreamichielan@virgilio.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Michielan
authors.affiliation: Clinical Research Unit, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Martinato
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Favarin
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Zanotto
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Caccaro
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Caruso
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Giacomo Carlo
authors.initials: GC
authors.lastname: Sturniolo
authors.affiliation: Department of Surgical, Gastroenterological and Oncological Sciences, Azienda Ospedaliera - Università di Padova, Padua, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: D'Incà
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D004506:Education, Nursing / Q000379:methods*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018718:Home Infusion Therapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D000069285:Infliximab / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010819:Physician's Role; D057184:Practice Patterns, Nurses'; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005765:Gastrointestinal Agents; D000069285:Infliximab; D006854:Hydrocortisone
keywords: Cost-benefit; Infusion reactions