Anders Fasth1, Jeanette Nyström. 1. Department of Paediatrics, University of Gothenburg, The Queen Silvia Children's Hospital, SE-416 85 Gothenburg, Sweden. anders.fasth@gu.se
Abstract
INTRODUCTION: Among patients with antibody deficiency, patient-reported outcomes are important for choosing between equally effective treatment regimens. PATIENTS AND METHODS: Twelve children (1.7-17.1 years) with primary immunodeficiency were switched from hospital-based intravenous IgG treatment to home treatment with subcutaneous IgG. Quality of life (Child Health Questionnaire) and health-care resource utilization were assessed at baseline and after 3 and 6 months. RESULTS: From the parents' perspective, significant improvements were seen after 6 months for mental health (median difference; 95% confidence interval, 15.0; 0.0, 22.5); change in health (1.0; 0.0, 2.0); and family activities (12.5; 2.1, 25.0). From the children's' perspective, significant improvements were seen for role/social limitations-emotional at 3 (22.2; 11.1, 33.3) and 6 months (22.2; 11.1, 66.7) and global health at 6 months (35.0; 15.0, 55.0). There were no significant improvements in other concepts. Subcutaneous IgG treatment significantly reduced absence days, days spent on hospital/physician visits, and health-care-related expenses. CONCLUSION: Switching to home-based subcutaneous IgG treatment led to significant improvements in quality of life and substantial cost savings.
INTRODUCTION: Among patients with antibody deficiency, patient-reported outcomes are important for choosing between equally effective treatment regimens. PATIENTS AND METHODS: Twelve children (1.7-17.1 years) with primary immunodeficiency were switched from hospital-based intravenous IgG treatment to home treatment with subcutaneous IgG. Quality of life (Child Health Questionnaire) and health-care resource utilization were assessed at baseline and after 3 and 6 months. RESULTS: From the parents' perspective, significant improvements were seen after 6 months for mental health (median difference; 95% confidence interval, 15.0; 0.0, 22.5); change in health (1.0; 0.0, 2.0); and family activities (12.5; 2.1, 25.0). From the children's' perspective, significant improvements were seen for role/social limitations-emotional at 3 (22.2; 11.1, 33.3) and 6 months (22.2; 11.1, 66.7) and global health at 6 months (35.0; 15.0, 55.0). There were no significant improvements in other concepts. Subcutaneous IgG treatment significantly reduced absence days, days spent on hospital/physician visits, and health-care-related expenses. CONCLUSION: Switching to home-based subcutaneous IgG treatment led to significant improvements in quality of life and substantial cost savings.
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