Infliximab in the Home - Does it Affect the Health-Related Quality of Life of Pediatric Patients with Inflammatory Bowel Disease?

Objectives Inflammatory bowel disease is characterized by an unpredictable course of relapsing and remitting symptoms often treated with infliximab. Historically infliximab was administered in the hospital setting or infusion centers. However, recently some providers have prescribed infliximab via home infusions. The goal of this study was to compare health-related quality of life in pediatric patients receiving infliximab in the home compared to those receiving infliximab in our hospital infusion center. Methods Inclusion criteria included English-speaking patients ages 9-17 years with a confirmed diagnosis of inflammatory bowel disease who were adherent with infliximab infusions. At subsequent visits, subjects (home infusions) and controls (hospital infusions) completed the IMPACT III, a self-administered health-related quality of life questionnaire. Results 38 patients (18 subjects, 20 controls) were included. Of the participants, 33 had Crohn's, 3 had ulcerative colitis and 2 had indeterminate colitis. The mean age at diagnosis was 11.5 years. Across the 6 domains assessed by the IMPACT III, there were no significant differences in health-related quality of life between subjects and controls. Conclusions While home infusions allow patients to receive therapy in comfortable settings at convenient times, location of infusions did not affect health-related quality of life scores. Despite this, home infusions are a convenient alternative to hospital-based infusions that should be considered in the patient requiring long-term therapy with infliximab. Measuring health-related quality of life in pediatric patients with inflammatory bowel disease may allow clinicians to identify additional needs and provide supplementary resources to improve their overall well-being.