Opinion
Video
Challenges in and Advice for Prescribing Subcutaneous Infusion Systems for Parkinson Disease
Author(s):
Panelists discuss how challenges in prescribing subcutaneous infusion systems might affect patient adherence and device management, best practices for patient education, and what additional data would benefit clinicians implementing newer Parkinson disease treatments.
Video content above is prompted by the following:
Challenges and Best Practices in Prescribing Subcutaneous Infusion Systems
Challenges in Prescribing Subcutaneous Infusion Systems: Physicians may face several challenges when prescribing subcutaneous infusion systems, especially regarding patient adherence and effective device management. Key challenges include:
- Patient Adherence
- Complexity and Learning Curve: Some patients may struggle with the technical aspects of using infusion systems, including proper device setup, administration, and troubleshooting.
- Comfort and Psychological Barriers: Patients may have concerns about pain, discomfort, or the aesthetic impact of wearing infusion devices. This can lead to nonadherence or inconsistent use.
- Lifestyle Adjustments: Patients may find it difficult to integrate infusion therapy into their daily routines, especially with systems requiring frequent adjustments or long-term use.
- Device Management
- Technical Failures: Infusion systems can malfunction or experience issues like occlusions, alarms, or interruptions in delivery, requiring the patient to manage potential device failures.
- Monitoring and Adjustments: Physicians must guide patients on how to adjust infusion settings or respond to any irregularities in the infusion process. This requires consistent follow-up to ensure proper therapy delivery and avoid complications like underdosing or overdosing.
- Storage and Handling: Proper handling and storage of medication and the infusion devices are essential to maintain efficacy and avoid contamination or damage.
Best Practices for Educating Patients on Subcutaneous Infusion Systems: Effective patient education is critical for ensuring that patients are well-informed about the use, benefits, and potential corollaries of 24-hour vs 16-hour subcutaneous infusion systems. Best practices include:
- Tailored Education
- Physicians should tailor education to the patient’s individual needs, considering factors like age, cognitive abilities, and technical aptitude.
- Clear instructions on how to use the infusion device should be provided in both verbal and written formats, accompanied by demonstration sessions. Videos or online resources can be helpful to reinforce key points.
- Addressing Benefits and Differences
- 24-Hour Systems: These systems typically offer continuous, steady medication delivery. Patients should understand the benefit of stable drug levels and how this can lead to more consistent symptom management.
- 16-Hour Systems: While they offer more flexibility, these systems may require more active involvement from the patient in terms of timing and monitoring. Educating patients on the trade-off between autonomy and the need for consistent administration is essential.
- Practical Demonstrations and Follow-Up
- Hands-On Training: Encourage patients to practice using the device with guidance during initial visits. Reassure them by providing a clear pathway for troubleshooting common problems.
- Ongoing Support: Offer follow-up appointments to address concerns, evaluate device usage, and ensure the patient is comfortable with both the technology and the therapy.
- Visual and Written Aids: Use diagrams, videos, and checklists to help patients remember steps in managing the infusion system effectively, including when and how to change sites, handle device alarms, and adjust settings.
- Emphasizing Lifestyle Integration
- Discuss how the infusion system can fit into their lifestyle, including meal timing, exercise, and daily routines. Reinforce the importance of maintaining a regular infusion schedule.
- Address psychological factors, such as how to manage feelings of discomfort or anxiety around the use of the device, and encourage positive coping strategies.
By addressing these challenges and providing thorough, tailored patient education, physicians can improve adherence, patient satisfaction, and the overall success of subcutaneous infusion therapy.
