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Marko Puzovic , Hana Morrissey , Patrick Ball

Abstract

Literature investigating the training of patients on medications self-injecting at home is lacking. This study explored patients’ and healthcare professionals’ (HCPs) experience with home parenteral therapy (HPT) in the UK. A clinical audit and survey of patient and HCP were conducted to inform the development of training pathway. The audit confirmed that the current training content or length are not well managed, documented or effectively communicated to the primary care providers (97.8% of discharge summaries). The cross-sectional survey was completed by 110 patients, who are on HPT and  39 HCPs involved with HPT in a UK hospital NHS Trust. HCPs and patients showed significantly different view about challenges patients faced as a result of HPT. Compared to patients, HCPs perception was that patients are mainly experiencing social implications (c² = 80.99, df = 1, p<0.001), followed by ability implications (c² = 55.21, df = 1, p<0.001), supply difficulty (c² = 24.48, df = 1, p<0.001) and health outcome implication (c² = 17.96, df = 1, p<0.001). Most patients indicated that they have not faced challenges (c² = 23.47, df = 1, p<0.001). The levels of training and patients support receive varied widely by condition. Patients reported inconsistency in being able to contact healthcare professional after hours when problems arise and confusion of which healthcare professional they should contact out of the treating team or the third-party supplier. There is a need to establish standardised HPT patients’ training to ensure their adherence to therapy and their safety in the community setting‎.

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