The power of infusion therapy
Recent advances in pharmaceutical science have produced a plethora of innovative, life-changing prescription drugs. Unfortunately, many of these drugs cannot be taken orally (like a pill) because they lose their effectiveness after exposure to the digestive system. Instead, many of them need to be given intravenously (IV) directly into patients’ veins.
Drugs given by the intravenous route given using a controlled dosage in facilities supervised by a healthcare professional are commonly referred to as “infusions” or infusion therapy. “Infusion centers have grown exponentially over the past few years as the number of patients receiving infusion therapy continues to increase,” explained Nicole Argenzia, nurse-in-charge at Hackensack Meridian Health who works in the infusion centers. since 1995.
Conditions treated with infusion therapy
Infusion therapy is used to treat a variety of serious and chronic illnesses. These include: cancer (chemotherapy), autoimmune and immuno-inflammatory diseases such as lupus, ulcerative colitis, rheumatoid arthritis, etc., immune deficiencies, bacterial infections resistant to oral antibiotics and, more recently, monoclonal antibody treatments for COVID-19. In addition, infusion therapy is frequently used to treat asthma, nausea and vomiting associated with cancer chemotherapy, pain, osteoporosis, osteoarthritis, dehydration, nutritional deficiencies, congestive heart failure. and blood clotting disorders.
Historically, infusion therapy has been almost exclusively linked to cancer chemotherapy treatments received in a hospital. This is no longer the case, as increasing demand has forced the infusion therapy industry to evolve and offer more flexible and convenient treatment options for its patients. A recent 2020 report from the National Infusion Center Association estimated that there are now more than 3,600 infusion centers in the United States and Puerto Rico.
Generally speaking, most infusion centers fall into four broad categories, including:
- Hospital infusion centers
- Infusion centers in the office
- Pharmacy infusion centers
- Autonomous infusion centers
Infusion centers associated with hospitals are generally locations owned or operated by hospitals. They are almost always located in a hospital or on the campus of a hospital facility. Hospital infusion centers are no longer the center of choice due to high costs, expensive waiting times, unusually long travel distances for patients and, most importantly, declining private insurance coverage. “Private insurance companies are forcing patients out of hospital infusion centers, whether they like it or not,” Argenzia said. “The choice of an infusion center is largely dictated by whether or not the insurance will cover the costs of the treatment,” she added.
Office infusion centers are places where a physician or group of physicians offers / administers infusions as part of their practice. Typically, there is a dedicated infusion space and trained staff supervising the center. Large practices may have multiple infusion centers to better meet the geographic and scheduling needs of their patients.
Most pharmacy infusion centers are physically located in a pharmacy where there is dedicated space for patients to receive treatment on site. Unlike hospital and office infusion centers, these centers usually do not have a doctor or nurse practitioner on site. Instead, infusions are usually supervised by registered nurses (with doctors on call). For this reason, under current government regulations, many pharmacy infusion centers are not reimbursed by Medicare and Medicaid.
The greatest proliferation of infusion centers has occurred in the category of stand-alone infusion centers. Stand-alone infusion centers (as the name suggests) are not located or affiliated with any hospital, physician group, or pharmacy. Instead, they are conveniently found in busy business offices or retail spaces and tend to cater to walk-in or outpatient patients seeking infusion therapy. Some of these locations do not have doctors or nurse practitioners and, therefore, are not Medicare / Medicaid reimbursable (although in some cases they may be covered by private insurers). At this point, Dr. Iuliana Shapira, chief medical officer of Regional Cancer Care Associates, warned: “Many stand-alone infusion centers do not have doctors or nurse practitioners on site. In an emergency, the safety and well-being of patients can be compromised because no one on the staff can intervene immediately. The only option is to dial 911.
What to expect
Regardless of the type of infusion center you are in, infusion therapy will be administered by physicians, registered nurses, nurse practitioners, or other qualified healthcare professionals. Before the actual infusion your identity will be confirmed, vital signs including blood pressure will be measured, any medications / vitamins / supplements you are taking will be reviewed and the correct medication and dose for the infusion will be confirmed. Infusions can range from 30 minutes to several hours.
Most modern facilities offer several individualized treatment rooms equipped with television, dimming lights, temperature control and even Wi-Fi, iPad and Netflix to ensure patient comfort. Dr Beaula Koduri, Founder of Hematology Oncology Care of New Jersey, a stand-alone infusion network, said, “We try to meet the needs and comfort of patients by providing the best possible treatment in a personalized and individualized setting.
After the infusion is finished, the intravenous line will be pulled out and you may need to ‘hang around’ for 15 to 30 minutes to make sure there are no allergic reactions or side effects. “Patient safety is always of paramount importance during infusion therapy,” Argenzia said.
As with all medical procedures, there are certain risks associated with infusion therapy. The most prominent are allergic reactions to the drug, including shortness of breath, flushing of the face, rash or hives, fever, chills, etc. Shapira and Koduri said. Other complications can include collapsed veins, phlebitis, and infection. Having trained healthcare personnel present during infusion therapy will help minimize the risk of possible treatments and other medical emergencies that may arise.
The bottom line
Infusion therapy is used to treat a growing number of chronic and serious illnesses. Although location, flexibility of schedules / extended hours and convenience are factors to consider, it is very important to ensure that an infusion center has properly trained healthcare staff, has a reputation for excellence and is covered by insurance before making a decision.
Cliff Mintz is a freelance medical / science writer and blogger with over 20 years of professional experience in the healthcare industry.
This article originally appeared in the Winter 2021 issue of Jersey’s Best. Subscribe here for detailed access to everything that makes Garden State great.