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N012. Role of ambulatory nursery patient education in adalimumab therapy

N. Cano, L. Oltra, M. Sanz, J. Hinojosa, Hospital de Manises, IBD unit, Manises, Spain

Background

Inflammatory bowel disease (IBD) has its clinical onset in teenage and early adulthood, representing an important cause of years-of-life lost. Biological therapies have shown excelent results in controlling disease course. However, parenteral administration requires repeated visits to day-hospital, with its consequent impact in quality-of-life. Furthermore, treatment adherence is a key factor for good IBD course control. At this point, subcutaneus Adalimumab therapy allows self adminstration by the patients, reducing hospital visits, with good clinical results and a suitable security profile. IBD-specialized-nursery has a key role in ambulatory patient eductation in subcutaneous administration and follow-up of Adalimumab therapy. In this study, we sought to analize our experience after starting a patient training and follow-up protocol for Adalimumab therapy in our institution.

Methods

Protocol description: IBD-specialized-nursery attending patients in specific consulting room. Daily programmed and demand visits, e-mail and telephonic assistance. First visit: demographic database register and hygienic-dietetic/lifestyle education. Following visits: weekly during induction period and monthly in subsequent visits. Educational reinforcement, treatment adherence follow-up and encouragement, and clinical course/therapy management doubts resolution. Adalimumab educational programme included model pen simulator, written information (subcutanous injection technique, side effects, alarm signs and safeguards), explanatory audivisuals and seric drug levels monitoring. Results analysis: patient satisfaction with IBD-unit, correct Adalimumab therapy administration performance and treatment adherence.

Results

69 patients included in Adalimumab educational programme in our unit. Mean follow-up 6.2±2.3 months. 100% of the patients keep suitable treatment adherence. 84.1% of the patients showed correct performance of Adalimumab subcutaneous administration technique after the first visit to our unit, 89.8% after 2 visits, 95.6% after 3 visits and 98.5% after 4 visits. 4.3% showed adverse events (bad disease control, adverse reactions) during follow-up period. 98.6% of the patients appreciated of the service offered by our IBD unit nursery consultory.

Conclusion

IBD-specialized-nursery consulting is an efficient initiative that could improve patient management of the disease course and reduce hospital visits. Our experience with Adalimumab self-adminstration subcutaneous programme may improve quality-of-life of our patients, allowing them to become more independent from hospital visits, with a suitable profile of effectiveness and security.