HOme Administration of Monoclonal antibodies: an Evaluation by Severe asthma patients

Background
Increasing numbers of patients with severe asthma are treated with biologicals (monoclonal antibodies) (anti IL-5, anti IgE, anti IL-4/IL-13). Currently these biologicals are administrated in the hospital (day care). Recently some of the biologicals are approved for home administration. Existing research, concerning home treatment for other chronic diseases, suggests improved patient satisfaction. We aim to evaluate home treatment of biologicals for severe asthma in an observational (before-after) study in three tertiary severe asthma centres in the Netherlands.

Objective:
1.To evaluate patient experience and satisfaction in home treatment with biologicals for severe asthma compared to in hospital treatment.
2. To compare two different strategies in starting home treatment with biologicals for severe asthma.
Both groups will start treatment with biologicals in hospital day care for the first 4 months. After evaluating response to therapy;
a. group 1: Patients start direct independent self-administration at home for 8 months.
b. group 2: Patients are supported by a specialized nurse for the first 4 months of home treatment, followed by self-administration for the remaining study period.
(Reslizumab will be supported by a nurse for the complete study period, because of the intravenous administration)
2. To evaluate the efficiency of home treatment compared to in hospital treatment (based on motivation, self-management behaviour and health care utilisation of severe asthma patients and the practical feasibility and costs of the home treatment service provided by the hospitals).

All patients are trained on drug administration and observed for appropriate technique, following a standardized education protocol, before home therapy.

Home administration of monocolonal antibodies for severe asthma improves patient satisfaction

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