ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P134

Optimization of chronic disease patient management: a pilot project on Sandostatin[R] LAR[R] treatment via homecare service

J Roemmler1, J Schopohl1, S Seibling2, S Petersenn2, A Rinke3 & T M Gress3

1Department of Internal Medicine of the University of Munich, Innenstadt, Munich, Germany; 2Department of Endocrinology of the University of Essen, Essen, Germany; 3Department of Gastroenterology of the University of Marburg, Marburg, Germany.

In chronic diseases patient (pat) often need continuous med treatment. In acromegaly and neuroendocrine tumors (GEP-NET), long term monthly injections of somatostatin analogues as Sandostatin® LAR® (SA®) are the treatment of choice. Problems regarding pat management and drug application might arise in not-specialized centers such as general practicioners (GP). To optimize pat’ management and compliance a homecare project* was piloted with specially trained nurses who applied SA® at pat’ home. Pat’ informed consent and doctors’ (doc) written delegation were prerequisites. Prior consulting between nurses, doc and pat took place, and GPs were informed. 3 centers included 41 pat (15 acromegaly, 25 GEP-NET, 1 thyroid-ca) from 02-10/2007.153 applications were conducted (Ø 3.7, doses: 15×30 mg, 21×20, 4×10). Fifty percent of pat received SA® for the first time. The project was evaluated by an independent survey interviewing 16 pat, 9 doc and 10 nurses. All pat were very satisfied. For 69% the well organised service was the most important benefit, for 44% the time saving. Eighty percent of the doc were very satisfied as the program showed benefits regarding pat’ satisfaction, time savings and low drop out rates (7/41 pat). Reasons for pat not participating were good contact, long experience and proximity to GP/clinic. Nurses were characterized as professional, friendly and well-organized. Nurses mentioned no or little problems with project start or med applications. Cooperation with doc was good. Training was found to require improvements especially regarding possible side effects and disease background. All participants recommended continuation of the homecare service. Homecare service is an innovative concept optimizing med care in chronic disease. Benefits are time saving for doc and pat, simplification of processes, professional injection of med resulting in higher pat’ satisfaction and compliance.

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