HOME INTRAVENOUS THERAPY IN CYSTIC-FIBROSIS - A PROSPECTIVE RANDOMIZED TRIAL EXAMINING CLINICAL, QUALITY-OF-LIFE AND COST ASPECTS

In this study, we set out to determine if home intravenous (i.v.) anti biotic therapy in adult patients with cystic fibrosis (CF) is a feasib le, effective and less costly alternative to hospitalization, and to a ssess the impact of home therapy on quality of life, The study was a p rospective, randomized, two-factor mixed design involving adults prese nting with respiratory exacerbations of CF. Patients were randomized s uch that they were discharged home after 2-4 days, or remained in hosp ital, Seventeen patients had 31 admissions (13 home and 18 hospital), Following 10 days of therapy, there were no significant differences be tween home or hospital arms with respect to body weight, 12 minute wal king distance, sputum weight, pulse oximetry, or improvement in lung f unction (forced expiratory volume in one second (FEV1), or forced vita l capacity (FVC)), Patients who remained in hospital were less fatigue d and noted a greater degree of mastery. Patients discharged early not ed less disruption to their family tife, personal life and sleeping pa ttern, The total cost for the home therapy arm was approximately half that of the hospital therapy arm, Home intravenous antibiotic therapy in patients with cystic fibrosis was a feasible, cost-effective altern ative to receiving therapy in hospital. Although there was no clinical compromise associated with home therapy, there were advantages and di sadvantages in terms of quality of life.