Comparing Patient Preference Between At-home and In-hospital Settings: Systematic Review and Meta-Analysis on Injectable Medications

Vincent Ebhabha, Hana Morrissey, Patrick Ball

Research output: Contribution to journalArticlepeer-review

Abstract

Out-of-hospital self-care in patients receiving injectable antibiotics or biologically derived medicines (biologics) is reported to significantly improve quality of life and reduce hospitalizations, but unexpected complications produce some negative outcomes and patient experience. This study aimed to compare patients' experience with long-term injectable therapies, in and out of the hospital setting. Two systematic reviews and meta-analyses were carried out using the most common out-of-hospital self-administered long-term injectable antibiotic and biologic therapies for patients diagnosed with infections or IBD, RA, or psoriasis. The first review investigated patient preference for self-administering subcutaneous injections at home (intervention) vs. intravenous injections in a hospital inpatient or outpatient setting. There was a statistically significant difference between the homecare (intervention) and hospital (control) group (p = 0.05) favoring the intervention. The second review was on injectable antibiotics. The results demonstrated that the use of injectable antibiotics, at home (intervention) or in hospital (control) produced similar benefits (p = 0.30 cure and p = 0.90 treatment failure) and harm (hospital admission after and during treatment p = 0.64, p = 0.99 respectively, disease complications p = 0.77 and medications side effects p = 0.15). This research found no substantial differences in patient outcomes based on the setting. Home care is an important option to support patient autonomy and well-being. The recent global COVID-19 pandemic further highlighted the importance of an option to continue long-term disease management without hospitalization.
Original languageEnglish
Pages (from-to)98-111
Number of pages14
JournalArchives of Pharmacy Practice
Volume14
Issue number3
DOIs
Publication statusPublished - 2023

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