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According to the FDA, “An infusion pump is a medical device that delivers fluids, such as nutrients and medications, into a patient’s body in controlled amounts. Infusion pumps are in widespread use in clinical settings such as hospitals, nursing homes, and in the home.”
Drugs that require infusion are typically distributed through specialty pharmacies, which offer not only access to medication and pumps but also can be where the therapy is delivered and/or where patients and healthcare workers are trained on how to use the pump on their own. Services they typically provide include evaluation and assessment, education and training for the patient or caregiver, inspection and consultation of the home environment, and catheter insertion. Using the education and training provided, many caregivers or patients are successfully able to administer their infusion therapies without an infusion nurse normally being present in the home.
Many infusion pharmacies also offer comprehensive care planning that considers common potential drug or equipment-related problems, therapy monitoring with specific patient goals, and coordination of activities with other providers such as home health agencies and physicians.
An aging population is driving growth in infusion therapy. Market research firm Frost and Sullivan estimates that the infusion pump market in the United States will grow from approximately $3.17 billion in 2012 to approximately $4.29 billion by 2019 at a compound annual growth rate of 4.4 percent.
Specialty infusion therapy pharmacies offer specialized services and a level of care that goes well beyond what retail pharmacies offer. Some infusion pharmacy organizations focus on providing a limited set of specialty infusion therapies, others provide the wide spectrum of traditional and specialty infusion therapies.
Infusion pumps must be programmed to deliver the proper rate of drug injection and the duration of the fluid delivery. Infusion technology has been developed to give doctors the ability to prescribe medication in extremely precise dosages at very precise rates and timing. They are most often used to deliver nutrients or medications, such as insulin or other hormones, antibiotics, chemotherapy drugs, and pain medications.
The technological advances have enabled safe and effective administration of many infusion therapies in the home, helping patients to resume normal lifestyles and work activities while recovering from illness, improving the cost-effectiveness of home care. As a result, home infusion therapy has evolved into a comprehensive medical therapy that is a much less costly alternative to inpatient treatment in a hospital or skilled nursing facility.
Because infusion pumps are frequently used to administer critical fluids, including high-risk medications, pump failures can have significant implications for patient safety. Many infusion pumps are equipped with safety features, such as alarms or other operator alerts that are intended to activate in the event of a problem.
According to the FDA, the majority of the adverse events that have been reported have been related to device design and engineering issues that either creates problems themselves or contribute to user error. The most common problems have been connected to software defects, user interface issues, or mechanical or electrical failures.
Specialty infusion pharmacies often deliver infusion therapy on site, offer patient training for mobile use, and work with home healthcare workers to ensure the pump is used properly and safely. The FDA has published risk reduction guidelines for home healthcare workers, patients, and healthcare providers. Recommendations include making sure any alarms are audible or visible enough to be immediately noticed and developing a backup plan in case of device malfunction.