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Home administration of intravenous methylprednisolone for multiple sclerosis relapses: the experience of French multiple sclerosis networks

¹ Réseau SINDEFI-SEP, Créteil, France
² Réseau Lorrain pour la SEP (LORSEP), Nancy, France
³ Réseau Bas-Normand pour la SEP (RBN-SEP), Caen, France
⁴ Réseau SEP Auvergne, Clermond-Ferrand, France

^* To whom correspondence should be addressed.

	Abstract

Background

One single center study has provided support for a home-based approach to the therapeutic management of multiple sclerosis (MS) relapse.

Objective

To report a multicenter series of patients with MS who were treated at home for a relapse with a 3-day course of intravenous methylprednisolone.

Methods

The home administration of intravenous methylprednisolone was coordinated by four MS networks in France; patients with MS with a relapse were referred by their neurologists, and treatment was administered by a local nurse. We analyzed the safety and efficiency of this approach and estimated the related cost savings. Patients completed a patient satisfaction questionnaire.

Results

Eight hundred and seven patients received intravenous methylprednisolone at home. The mean disease duration was 10.3 ± 7.9 years. Treatment was often prescribed by community-based neurologists. The delay between prescription and treatment was 2.8 ± 0.5 days if treatment was initiated at home and 1.9 ± 3.0 days if treatment was initiated in hospital (the subsequent two injections were always administered at home). Home treatment was well tolerated; three serious side effects requiring hospital transfer were observed (anxiety, thoracic oppression, and arrhythmia), which were fully reversible. Overall, 93.8% of patients were satisfied with the treatment approach, and 98% wished to receive future treatment courses at home. The overall cost savings of home-based treatment versus hospital-based treatment were evaluated at EUR1,091,482.

Conclusion

Safety data, patient satisfaction, and economic considerations support home-based treatment of MS relapses with intravenous methylprednisolone, provided strict patient selection criteria are observed and the process is coordinated and closely monitored by an MS network.

Key Words: home, methylprednisolone, multiple sclerosis, network, relapse, treatment

First published on June 25, 2009, doi:10.1177/1352458509106710

Multiple Sclerosis 2009;15:1085.

A more recent version of this article appeared on September 1, 2009


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