Home Treatment
Home Treatment Benefits
Home treatment for hemophilia patients at Cincinnati Children's Hospital Medical Center is much more than a convenience. While it does help to normalize an individual's lifestyle by decreasing trips to the hospital and enabling patients and families to spend more time at things they enjoy, it also offers significant therapeutic advantages.
Home treatment allows early treatment, which not only reduces pain and discomfort, but also helps to avoid orthopedic (joint) complications and permanent joint damage. Further, early treatment can reduce the number of infusions needed to treat a bleeding episode and significantly reduce the total consumption of costly clotting factor concentrate.
Finally, home treatment facilitates the implementation of prophylactic treatment strategies that rely on the regular infusion of clotting factor to prevent bleeding in patients with severe factor deficiencies.
Home Treatment Eligibility
A variety of factors determine the appropriateness of a home treatment regimen for each patient. These factors encompass aspects of the specific disorder as well as the willingness and ability of patient and family members to take on treatment responsibilities.
Major issues involved in determining home treatment eligibility include the type and history of bleeding patterns for the patient, as well as his or her level of venous access and the type of venous access device that would be required. The age of the patient and the ability to understand, cooperate and participate in the treatment, as well as motivation among family members to learn the procedures involved, are also requirements.
Families must be willing to maintain accurate records of infusions and bleeding episodes. A willingness to participate in safe waste disposal practices is also an important prerequisite for eligibility.
Finally, those families considering prophylaxis must make a major commitment toward establishing and maintaining a regular treatment schedule.
Education and Training
The staff will educate patients and family members who qualify for the home treatment program in a basic knowledge of hemophilia and relevant strategies for managing it at home. Specific instruction will focus on how to perform the following tasks:
- Assessing the need for home treatment
- Calculating dosage
- Inserting the needle (venipuncture)
- Administering clotting factor (infusing)
- Maintaining bleeding logs
- Handling emergency situations
- Reporting unusual bleeding episodes or complications
- Disposing of used or contaminated equipment and supplies
- Following universal infection control procedures
- Handling accidental needle sticks
- Contacting nursing staff with questions and concerns
After successfully completing training and demonstrating adequate skills and understanding, patients and family members are approved for participation in home treatment. The individuals then sign an informed consent form, which documents the successful completion of instruction in the home treatment program.
Continued Participation in Home Treatment
Continued participation in the Home Treatment Program requires evaluation of patients and families in the following areas:
- Prompt communication to the staff of serious or potentially life-threatening bleeding episodes, adverse reactions, or any other unusual events or outcomes related to home treatment
- Regular participation in comprehensive evaluations at the hemophilia clinic
- Timely completion and submission of monthly bleeding logs
- Completion of a yearly reevaluation by the program staff, which tests the family's knowledge and skills associated with safe home treatment practices
