Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Loris Pironi; Ezra Steiger; Chrisoffer Brandt; Francisca Joly; Geert Wanten; Cecile Chambrier; Umberto Aimasso; Anna Simona Sasdelli; Sarah Zeraschi; Darlene Kelly; Kinga Szczepanek; Amelia Jukes; Simona Di Caro; Miriam Theilla; Marek Kunecki; Joanne Daniels; Mireille Serlie; Florian Poullenot; Jian Wu; Sheldon C Cooper; Henrik H Rasmussen; Charlene Compher; David Seguy; Adriana Crivelli; Maria C Pagano; Sarah-Jane Hughes; Francesco W Guglielmi; Nada Rotovnik Kozjek; Stéphane M Schneider; Lyn Gillanders; Lars Ellegard; Ronan Thibault; Przemysław Matras; Anna Zmarzly; Konrad Matysiak; Andrè Van Gossum; Alastair Forbes; Nicola Wyer; Marina Taus; Nuria M Virgili; Margie O'Callaghan; Brooke Chapman; Emma Osland; Cristina Cuerda; Peter Sahin; Lynn Jones; Andre Dong Won Lee; Luisa Masconale; Paolo Orlandoni; Ferenc Izbéki; Corrado Spaggiari; Marta Bueno; Maryana Dotchinova-Simeonova; Carmen Garde; Aurora E. Serralde-Zúñiga; Gabriel Olveira; Zelijko Murilo; Laszlo Czako; Gintautas Kekstas; Alejandro Sanz-Paris; Estrella Petrina Jáuregui; Ana Zugasti Murillo; Eszter Schafer; Jann Arends; José P. Suárez-Llanos; Simon Lal; Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN

doi:10.1016/j.clnu.2019.03.010

Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Loris Pironi, Ezra Steiger, Chrisoffer Brandt, Francisca Joly, Geert Wanten, Cecile Chambrier, Umberto Aimasso, Anna Simona Sasdelli, Sarah Zeraschi, Darlene Kelly, Kinga Szczepanek, Amelia Jukes, Simona Di Caro, Miriam Theilla, Marek Kunecki, Joanne Daniels, Mireille Serlie, Florian Poullenot, Jian Wu, Sheldon C CooperHenrik H Rasmussen, Charlene Compher, David Seguy, Adriana Crivelli, Maria C Pagano, Sarah-Jane Hughes, Francesco W Guglielmi, Nada Rotovnik Kozjek, Stéphane M Schneider, Lyn Gillanders, Lars Ellegard, Ronan Thibault, Przemysław Matras, Anna Zmarzly, Konrad Matysiak, Andrè Van Gossum, Alastair Forbes, Nicola Wyer, Marina Taus, Nuria M Virgili, Margie O'Callaghan, Brooke Chapman, Emma Osland, Cristina Cuerda, Peter Sahin, Lynn Jones, Andre Dong Won Lee, Luisa Masconale, Paolo Orlandoni, Ferenc Izbéki, Corrado Spaggiari, Marta Bueno, Maryana Dotchinova-Simeonova, Carmen Garde, Aurora E. Serralde-Zúñiga, Gabriel Olveira, Zelijko Murilo, Laszlo Czako, Gintautas Kekstas, Alejandro Sanz-Paris, Estrella Petrina Jáuregui, Ana Zugasti Murillo, Eszter Schafer, Jann Arends, José P. Suárez-Llanos, Simon Lal, Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Abstract

BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF).

METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions.

RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001).

CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

Originalsprog	Engelsk
Tidsskrift	Clinical Nutrition
Vol/bind	39
Udgave nummer	2
Sider (fra-til)	585-591
Antal sider	7
ISSN	0261-5614
DOI	https://doi.org/10.1016/j.clnu.2019.03.010
Status	Udgivet - feb. 2020

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10.1016/j.clnu.2019.03.010

Home parenteral nutrition provisionAccepteret manuskript, 1,75 MBLicens: CC BY-NC-ND 4.0

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Pironi, L., Steiger, E., Brandt, C., Joly, F., Wanten, G., Chambrier, C., Aimasso, U., Sasdelli, A. S., Zeraschi, S., Kelly, D., Szczepanek, K., Jukes, A., Di Caro, S., Theilla, M., Kunecki, M., Daniels, J., Serlie, M., Poullenot, F., Wu, J., ... Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN (2020). Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey. Clinical Nutrition, 39(2), 585-591. Advance online publication. https://doi.org/10.1016/j.clnu.2019.03.010

@article{aa73055fbdbe4ee9ae22560e5a865b94,

title = "Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey",

abstract = "BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF).METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions.RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001).CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.",

keywords = "Cancer, Home parenteral nutrition, Intestinal failure, Intravenous supplementation",

author = "Loris Pironi and Ezra Steiger and Chrisoffer Brandt and Francisca Joly and Geert Wanten and Cecile Chambrier and Umberto Aimasso and Sasdelli, {Anna Simona} and Sarah Zeraschi and Darlene Kelly and Kinga Szczepanek and Amelia Jukes and {Di Caro}, Simona and Miriam Theilla and Marek Kunecki and Joanne Daniels and Mireille Serlie and Florian Poullenot and Jian Wu and Cooper, {Sheldon C} and Rasmussen, {Henrik H} and Charlene Compher and David Seguy and Adriana Crivelli and Pagano, {Maria C} and Sarah-Jane Hughes and Guglielmi, {Francesco W} and Kozjek, {Nada Rotovnik} and Schneider, {St{\'e}phane M} and Lyn Gillanders and Lars Ellegard and Ronan Thibault and Przemys{\l}aw Matras and Anna Zmarzly and Konrad Matysiak and {Van Gossum}, Andr{\`e} and Alastair Forbes and Nicola Wyer and Marina Taus and Virgili, {Nuria M} and Margie O'Callaghan and Brooke Chapman and Emma Osland and Cristina Cuerda and Peter Sahin and Lynn Jones and {Won Lee}, {Andre Dong} and Luisa Masconale and Paolo Orlandoni and Ferenc Izb{\'e}ki and Corrado Spaggiari and Marta Bueno and Maryana Dotchinova-Simeonova and Carmen Garde and Serralde-Z{\'u}{\~n}iga, {Aurora E.} and Gabriel Olveira and Zelijko Murilo and Laszlo Czako and Gintautas Kekstas and Alejandro Sanz-Paris and J{\'a}uregui, {Estrella Petrina} and Murillo, {Ana Zugasti} and Eszter Schafer and Jann Arends and Su{\'a}rez-Llanos, {Jos{\'e} P.} and Simon Lal and {Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN}",

year = "2020",

month = feb,

doi = "10.1016/j.clnu.2019.03.010",

language = "English",

volume = "39",

pages = "585--591",

journal = "Clinical Nutrition",

issn = "0261-5614",

publisher = "Elsevier",

number = "2",

}

Pironi, L, Steiger, E, Brandt, C, Joly, F, Wanten, G, Chambrier, C, Aimasso, U, Sasdelli, AS, Zeraschi, S, Kelly, D, Szczepanek, K, Jukes, A, Di Caro, S, Theilla, M, Kunecki, M, Daniels, J, Serlie, M, Poullenot, F, Wu, J, Cooper, SC, Rasmussen, HH, Compher, C, Seguy, D, Crivelli, A, Pagano, MC, Hughes, S-J, Guglielmi, FW, Kozjek, NR, Schneider, SM, Gillanders, L, Ellegard, L, Thibault, R, Matras, P, Zmarzly, A, Matysiak, K, Van Gossum, A, Forbes, A, Wyer, N, Taus, M, Virgili, NM, O'Callaghan, M, Chapman, B, Osland, E, Cuerda, C, Sahin, P, Jones, L, Won Lee, AD, Masconale, L, Orlandoni, P, Izbéki, F, Spaggiari, C, Bueno, M, Dotchinova-Simeonova, M, Garde, C, Serralde-Zúñiga, AE, Olveira, G, Murilo, Z, Czako, L, Kekstas, G, Sanz-Paris, A, Jáuregui, EP, Murillo, AZ, Schafer, E, Arends, J, Suárez-Llanos, JP, Lal, S & Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN 2020, 'Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey', Clinical Nutrition, bind 39, nr. 2, s. 585-591. https://doi.org/10.1016/j.clnu.2019.03.010

TY - JOUR

T1 - Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients

T2 - An international survey

AU - Pironi, Loris

AU - Steiger, Ezra

AU - Brandt, Chrisoffer

AU - Joly, Francisca

AU - Wanten, Geert

AU - Chambrier, Cecile

AU - Aimasso, Umberto

AU - Sasdelli, Anna Simona

AU - Zeraschi, Sarah

AU - Kelly, Darlene

AU - Szczepanek, Kinga

AU - Jukes, Amelia

AU - Di Caro, Simona

AU - Theilla, Miriam

AU - Kunecki, Marek

AU - Daniels, Joanne

AU - Serlie, Mireille

AU - Poullenot, Florian

AU - Wu, Jian

AU - Cooper, Sheldon C

AU - Rasmussen, Henrik H

AU - Compher, Charlene

AU - Seguy, David

AU - Crivelli, Adriana

AU - Pagano, Maria C

AU - Hughes, Sarah-Jane

AU - Guglielmi, Francesco W

AU - Kozjek, Nada Rotovnik

AU - Schneider, Stéphane M

AU - Gillanders, Lyn

AU - Ellegard, Lars

AU - Thibault, Ronan

AU - Matras, Przemysław

AU - Zmarzly, Anna

AU - Matysiak, Konrad

AU - Van Gossum, Andrè

AU - Forbes, Alastair

AU - Wyer, Nicola

AU - Taus, Marina

AU - Virgili, Nuria M

AU - O'Callaghan, Margie

AU - Chapman, Brooke

AU - Osland, Emma

AU - Cuerda, Cristina

AU - Sahin, Peter

AU - Jones, Lynn

AU - Won Lee, Andre Dong

AU - Masconale, Luisa

AU - Orlandoni, Paolo

AU - Izbéki, Ferenc

AU - Spaggiari, Corrado

AU - Bueno, Marta

AU - Dotchinova-Simeonova, Maryana

AU - Garde, Carmen

AU - Serralde-Zúñiga, Aurora E.

AU - Olveira, Gabriel

AU - Murilo, Zelijko

AU - Czako, Laszlo

AU - Kekstas, Gintautas

AU - Sanz-Paris, Alejandro

AU - Jáuregui, Estrella Petrina

AU - Murillo, Ana Zugasti

AU - Schafer, Eszter

AU - Arends, Jann

AU - Suárez-Llanos, José P.

AU - Lal, Simon

AU - Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN

PY - 2020/2

Y1 - 2020/2

N2 - BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF).METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions.RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001).CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

AB - BACKGROUND & AIMS: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF).METHODS: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions.RESULTS: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001).CONCLUSIONS: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care.

KW - Cancer

KW - Home parenteral nutrition

KW - Intestinal failure

KW - Intravenous supplementation

UR - http://www.scopus.com/inward/record.url?scp=85064135500&partnerID=8YFLogxK

U2 - 10.1016/j.clnu.2019.03.010

DO - 10.1016/j.clnu.2019.03.010

M3 - Journal article

C2 - 30992207

SN - 0261-5614

VL - 39

SP - 585

EP - 591

JO - Clinical Nutrition

JF - Clinical Nutrition

IS - 2

ER -

Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients: An international survey

Abstract

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