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Home administration of intravenous methylprednisolone for multiple sclerosis relapses: the experience of French multiple sclerosis networks
Multiple Sclerosis, 06/30/09
Creange A et al. – Safety data, pt satisfaction, and economic considerations support home-based treatment of multiple sclerosis (MS) relapses with intravenous methylprednisolone, provided strict pt selection criteria are observed and the process is coordinated and closely monitored by an MS network.
Methods- Report of a multi-center series of MS pts treated at home for a relapse with a 3-day course of intravenous (IV) methylprednisolone
- Home administration of intravenous methylprednisolone coordinated by 4 MS networks in France
- Relapsed MS pts referred by neurologists
- Treatment administered by local nurse
- Analysis of safety and efficiency of this approach
- Estimation of related cost savings
- Pt satisfaction questionnaire for all pts
- IV methylprednisolone at home for 807 pts
- Mean disease duration: 10.3 ± 7.9 yrs
- Treatment often prescribed by community-based neurologists
- Delay between prescription and treatment: 2.8 ± 0.5 days if treatment initiated at home vs 1.9 ± 3.0 days if treatment initiated in hospital (subsequent 2 injections always at home)
- Home treatment: well tolerated
- Serious side effects requiring hospital transfer: anxiety, thoracic oppression, and arrhythmia; all fully reversible
- Overall, 93.8% of pts satisfied with treatment approach; 98% wished to receive future treatment courses at home
- Overall cost savings of home-based treatment vs hospital-based treatment evaluated at EUR1,091,482
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