Practical Considerations for Self-Administration of Subcutaneous Immunoglobulin G Utilizing Recombinant Human Hyaluronidase, an Advanced Method of Subcutaneous Administration: A Nurse's Perspective.
An approved subcutaneous infusion of immunoglobulin G using recombinant human hyaluronidase (IGHy) allows adult patients with primary immunodeficiency disease to self-administer every 3 to 4 weeks using 1 to 2 subcutaneous infusion site(s). This article reviews the practical considerations for nurses to simplify patient education and training. Key considerations include pump choice and parameters, ancillary supplies, and technique. Patient education includes infusion log upkeep and management of potential reactions. Educational initiatives should be designed to meet specific patient needs. Successful IGHy self-administration depends on proper patient training and continuing interaction between the health care team and the patient to optimize the patient experience.
Allergy Partners of North Texas Research, Dallas, Texas (Ms Miars); Division of Basic and Clinical Immunology, University of California, Irvine, Irvine, California (Dr Tran); and Baxalta US Inc, now part of Shire, Knoxville, Tennessee (Ms Duff). Linda K. Miars, LVN, is affiliated with Allergy Partners of North Texas Research in Dallas, Texas. Her interests in the field of infusion therapy include patient education and management of adverse reaction to immunoglobulin G (IgG) administered subcutaneously (IGSC) and IgG administered intravenously (IGIV). Michelle Tran, DNP, FNP-C, is affiliated with the University of California, Irvine in Irvine, California. Her interests in the field of infusion therapy include the management of IGIV adverse reactions and barriers to weight loss in patients with primary immunodeficiency diseases. Kimberly Duff, BSN, RN, has been a manager of clinical education in global medical affairs for Shire for the past 5 years. She has 31 years of experience in nursing, with the last 17 in the field of immunology. She provides clinical expertise to support the development of new products and helps others understand the patient experience. Ms Miars and Dr Tran have no conflicts of interest to report. Ms Duff is an employee of Shire. Editorial support was provided by BlueMomentum, a division of Ashfield Healthcare Communication (a UDG Healthcare plc company) and was funded by Shire.
Linda K
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D000328:Adult; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage*; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007153:Immunologic Deficiency Syndromes / Q000188:drug therapy; D055104:Infusions, Subcutaneous; D024802:Nurse's Role / Q000523:psychology*; D012646:Self Administration
D007074:Immunoglobulin G; D006821:Hyaluronoglucosaminidase