Immunology - Home Therapy with Subcutaneous Immunoglobin

You have been diagnosed with antibody deficiency and you require immunoglobulin (antibody) replacement therapy.

This can be given as a short or long term treatment depending on your condition.

The treatment is either given intravenously (into the vein) or subcutaneously (under the skin). Immunoglobulin preparations can be given safely at home.

The training programme at Salford Care Organisation teaches suitable and willing patients and their carers how to self- administer either subcutaneous or intravenous immunoglobulin infusions.

Home therapy

• We offer home therapy for all patients. We teach patients and their carers how to self-administer subcutaneous immunoglobulin. There are several options, one via a small pump as shown in the pictures below. Rapid push or a facilitated subcutaneous immunoglobin administered every 3 weeks.
• We will inform your GP that you are self-administering the infusions at home
• The Immunology nursing team will arrange the registration and installation of the homecare service with a private healthcare company funded by the NHS

How will I be prepared for this training?

• Prior to commencing training, we will discuss with you whether your home environment is suitable. As well as the process of taking delivery and storing the Immunoglobulin and equipment which may include a small fridge
• You will start the home therapy training on a day unit at Salford Care Organisation with the Immunology specialist nurse
• You will be given home therapy information regarding the self-administration of Immunoglobulin
• If your relative/carer is to be trained, they will need to accompany you for all training sessions

What will happen during the training?

On the first training session:

• The specialist nurse will administer the infusion and show you all the equipment required
• There will be plenty of time to familiarise yourself with the process, the equipment and to ask questions

On subsequent sessions under supervision:

• You will self-administer your infusion on several occasions during your training. 6-8 weekly sessions are usually sufficient, but sometimes more or less may be required
• We can adapt the teaching to your learning style and use appropriate guides and aids i.e. photos/videos to help you complete the home therapy programme
• You will be given a short questionnaire once training is complete to ensure that you have understood all aspects of administering immunoglobulin therapy. Any issues that may arise will be discussed with you before you commence therapy at home
• The Immunology nurses will instruct the homecare company to deliver Immunoglobulin and equipment to your home ready for you to start self-administering
• A home visit can be carried out to identify any further problems or issues with self-administering the treatment at home

Benefits of home therapy

• You can self-administer in the comfort of your own home at a time which suits you
• You will not need to take time off work or college to attend the hospital for infusions
• You will have more independence and control over your treatment

What are the consequences of not complying with regular home treatment?

• You will have recurrent and frequent infections
• You may have serious infections, such as pneumonia and possible severe life-threatening infections such as septicaemia and meningitis

Are there any alternatives to home therapy?

• You can receive infusions at Salford Care Organisation which are administered by a different nursing team
• You may be able to receive infusions at a hospital nearer to your home if that can be arranged

What happens once I am self-administering at home?

• It is vital to complete your infusion log forms by recording the batch number of the immunoglobin and send the completed forms to the Immunology team via post or email
• All batch numbers from your immunoglobulin are recorded on a national NHS England database. If we do not receive these batch numbers, your prescription for your immunoglobin may not be renewed and treatment stopped
• Bloods are monitored every 6 months; we will discuss arrangements for obtaining regular blood samples at your clinic visits
• You will need to be assessed every 24 months to check you are self-administering correctly
• You must attend your Immunology follow-up appointment which is booked at least once per year. In addition to this, you may have a telephone consultation after six months. You will receive an appointment letter via post
• If you have any worries or concerns regarding your treatment, you can contact the Immunology nurses or the secretary on the numbers below
• We do not however, provide 24 hour or emergency cover. If you need urgent attention contact your GP or emergency services

When NOT to have your infusion

• If unwell with a temperature
• Active infection
• Flu like symptoms If you do experience any of the above hold off immunoglobulin treatment until you are feeling better

Step by Step Guide to Self-administrating

If you require further information or wish to discuss any issues with the immunology specialist nurses please contact us on the contact details below.

Immunology Specialist Nurses
Tel: 0161 206 5576 Office hours are Monday to Friday 8am to 4pm (excluding bank holidays)
Email: salfordimmunology.nurses@nca.nhs.uk

Other useful resources

www.northerncarealliance.nhs.uk

www.immunodefficiencyuk.org

www.ipopi.org.uk www.ukpips.org.uk