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Frequently Asked Questions – Specialty Infusion Services
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- How do I make a referral?
For infusion, home health or hospice needs anywhere in Ohio, call our dedicated referral line at 1.888.873.7888.
- What is Infusion Therapy?
For an extensive overview of what comprises the services we provide, visit the National Home Infusion Association website (www.nhianet.org - patient resources).
- What is considered Specialty Infusion?
Specialty Infusion incorporates the principles of “pharmaceutical” care and therapy management for patients with chronic conditions requiring long-term intravenous medication therapy. The unique characteristics of this “service class” are that these therapies are usually intermittent in nature (i.e. administered on a weekly, monthly or as needed basis), nursing services are often required for initiation of therapy and these therapies generally are preventative in nature (intended to minimize the onset or exacerbation of a condition).
- Where are your locations?
We provide services into a six-state region with two pharmacy locations, Cleveland and Columbus.
- What are your pharmacy hours?
A pharmacist is available at the Cleveland office between 8 a.m. and 5 p.m. Monday through Friday, please dial 1.888.873.8999. The Columbus office hours are 8:30 a.m. to 5:00 p.m., our toll free number is 1.866.850.9101. Our answering service is available to page a pharmacist evenings and weekends.
- Whom do I call when I have questions about my therapy?
Please call the office during the hours indicated above and ask to speak with a pharmacist. For Cleveland please call 1.888.873.8999 and for Columbus dial 1.866.850.9101. Outside of office hours you wil be connected to our answering service. Please ask for the pharmacist to be paged.
- The following are questions specific to Immunoglobulin/IVIG and Immune System Disorders,
(for questions on Hemophilia, click here).
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- What is IVIG Therapy?
IVIG Therapy is the infusion of a prepared solution of immune globulins containing antibodies normally present in adult human blood. These immune globulins are proteins that provide protection against diseases. This therapy is given to persons who are unable to produce enough immunoglobulin antibodies to fight off bacteria and viruses or have an autoimmune disorder.
- Where does IVIG come from?
IVIG is prepared from human plasma pooled from thousands of donors and contains the needed antibodies. This plasma is screened and tested.
- What are Immune System Disorders?
The immune system defends our body from attacks by destructive viruses and bacteria. With an immune system disorder, the body has difficulties in fighting these attacks. In extreme cases, the faulty immune system may actually attack the body’s own cells.
- What are the different types of Immune System Disorders?
Primary Immune Deficiency Disorders (PIDD) are naturally occurring defects of the immune systems in which the ability to produce antibodies is reduced or absent. PIDD is genetically based and generally inherent.
Secondary Immune Deficiency Disorders are a result of environmental “exposures” or of diseases such as cancer or HIV. In these incidences a person does have an immune system, but it fails to perform adequately.
For Autoimmune Disorders it is not well understood as to what causes the autoimmune response to take place, but it is believed to be the result of an overactive immune system. As a result, the malfunctioning immune system attacks the body’s own cells.
- How does IVIG help patients with immune deficiency disorders?
In immune deficiency, IVIG therapy provides an immediate source of antibodies offering protection from potentially harmful bacteria and viruses. In Autoimmune Disorders, IVIG therapy will cause the overactive immune system to slow down, therefore minimizing the autoimmune reaction or attack on the body’s own cells.
- How frequently is IVIG given?
IVIG is generally given intravenously once a month as replacement therapy for primary and secondary immune deficiencies. For autoimmune disorders, infusions are given as problems arise.
- How is IVIG administered?
IVIG therapy is given intravenously and takes approximately 3-4 hours to infuse.
- Where is IVIG infused?
IVIG can be infused in the hospital inpatient and outpatient setting, at an infusion suite or at home. Receiving IVIG therapy in the home minimizes exposure to bacteria and viruses that may be encountered in a hospital or outpatient setting. It provides a safe, comfortable environment and allows these treatments to be given while resuming one’s daily routines. Our nurses are experienced with the IVIG administration and will provide the monitoring required.
- Can IVIG be used with other therapies?
It can be used in conjunction with other medications, but IVIG should always be infused separately and never mixed in the same bag with other medications.
- What are potential risks associated with IVIG therapy?
Infusion related reactions tend to be few and are usually managed by slowing down the infusion, stopping the infusion for a brief period and/or using pre-medications. These infusion-related reactions include fever, chills, headache, lightheadedness, nausea, and chest discomfort.
- Where can I find more information on Immune Deficiency Disorders?
The following Web sites all provide educational information on Immune Deficiency Disorders.
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 8. The following are questions specific to Hemophilia.
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- What is Hemophilia?
Hemophilia is a rare genetic disorder in which a person’s blood does not clot properly. Their body does not produce enough of the blood-clotting proteins called factors or they are missing a certain factor. The body requires these clotting factors to stop bleeding after injury and to promote healing of the injured site. Factor therapy works as a substitute for the missing or non-functioning clotting factor VIII or IX protein. Clotting factors begin to work immediately to form a clot. This replacement therapy works for approximately 24 hours. If bleeding continues, additional infusions of factor may be necessary.
- How does a person get Hemophilia?
Hemophilia is called the sex-linked disorder because it is carried on the x chromosome. The hemophilia gene is carried down from a parent to a child. Women do not usually have hemophilia, but carry the disorder and pass it on to their sons who then have the disorder. Women who are carriers have a 50% chance of having a boy with hemophilia and a 50% chance of having a girl who is a carrier. Men with hemophilia pass the gene on to their daughters, but not to their sons. About 33% of new cases are caused by spontaneous mutation of the gene, which means that there was no history of hemophilia in the family before.
- Are there different types of Hemophilia?
The two most common types of hemophilia are Hemophilia A, referred to as Classical Hemophilia and Hemophilia B, referred to as the Christmas Disease. In Hemophilia A, the person has a Factor VIII deficiency. In Hemophilia B, the person has a Factor IX deficiency. Both types vary in severity from mild, moderate to severe.
- How common is Hemophilia?
The incidence is about 1 in 7,500 male births. There are currently about 20,000 people with Hemophilia in the United States.
- How is Hemophilia treated?
Hemophilia is treated by replacing the missing factor VIII or IX in the blood. It is administered by IV, which means a needle is placed in a vein and the missing factor is injected through the IV. It takes approximately 20-30 minutes to infuse. Bleeding stops when enough clotting factor reaches the bleeding site. People can go to the Hemophilia treatment centers for infusion, home infusion companies come to the home and infuse, or people are taught to self infuse. Parents are taught to start infusing their children as young as 2 or 3 years of age. As they get older, they are taught to infuse themselves.
- What is the cost of treatment?
Average treatments can run as high as $250,000 annually. It can be higher if a person has an inhibitor.
- Why is the treatment so expensive?
Due to complications of blood products, i.e. HIV, Hepatitis and other viruses, a significant amount of research has gone into play to make the factor replacement products safer. The newest technology is a genetically engineered factor called recombinant. Recombinant products are infused without transmission of blood-borne pathogens in the treatment of Hemophilia. Although the cost of this latest research and technology has increased the cost of factor, it has decreased the complications making treatment safer for people requiring factor infusions. This is very comforting to people who infuse.
- What is an inhibitor?
Inhibitors are antibodies to the coagulation product (i.e. factor VIII or IX) that attack and destroy factor VIII or IX proteins in clotting factor concentrates, thus making the treatment ineffective. In other words, the body rejects the newly infused factor product. Approximately 15% of people with severe Hemophilia A will develop inhibitors at some time. Inhibitor development in Hemophilia B is very rare, less than 1%. Inhibitors emerge after just a few treatments. In general, the more treatments a person had without developing inhibitors, the less likely he is to develop an inhibitor.
- Where can I find more information on Hemophilia?
Local and state Hemophilia chapters, The Hemophilia Federation of America (www.hemophiliafed.org) and The National Hemophilia Foundation (www.hemophilia.org)
all provide educational information on Hemophilia.
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