Innovative trial sees cardiology patient receiving specialist drug treatment at home

Warrington’s Community Intravenous Therapy (IV) Service has set up an innovative new trial with a hospital Cardiologist.

Josephine Creaghan and Rebecca Redfern

The trial supports a new way of treating patients with a specialist heart condition out of hospital and in their own homes.

Warrington and Halton Hospitals NHS Foundation Trust Cardiology Consultant Dr Farag approached Warrington’s IV Service, provided by Bridgewater, earlier this year to set up the partnership.

Warrington’s Community IV Therapy Service is a team of specialist nurses who prevent hospital admissions and aid the early discharge of hospital patients by providing IV drug treatments in patients’ homes or at Bath Street Health and Wellbeing Centre.

They usually administer antibiotics and provide support to chemotherapy patients with conditions such as cancer, soft tissue and skin infections, diabetic foot ulcers and severe infections in the chest, urine, spine and bones.

A new trial was set up to examine the effectiveness of extending their support to patients with heart failure, a condition which results in gross peripheral swelling.

Rebecca Redfern, Community IV Lead Nurse for Bridgewater said:

“We are always looking to improve our service and offer as much support as we can to aid the recovery of patients in their own homes so they can either leave hospital early or avoid going into hospital altogether. By keeping patients out of hospital and in their own homes, they are more comfortable and rested and they also have a reduced risk of contracting an infection.

“My background is in acute medicine, so I was excited to be approached by Dr Farag to start a small trial of treating patients with heart failure who have swelling in the lower legs. Although this condition would usually be treated using the drug Furosemide administered by IV in hospital, Dr Farag approached us about trialling at home treatment for these patients.”

Dr Farag, Consultant Cardiologist at Warrington and Halton Hospitals NHS Foundation Trust said:

“Decompensated heart failure is one of the common reasons for prolonged hospital admissions. My idea was to explore whether in suitable selected patients we could avoid hospital admission altogether by safely providing intravenous diuretic injections at home. I was pleased that Bridgewater’s Community IV Team were happy to participate in the project.”

The first patient identified as part of the trial was Josephine Creaghan, a 75 year old woman from Culcheth. Josephine has Mitral Stenosis resulting in swelling of her lower legs.

She was chosen for the trial to receive her treatment at home and was keen to participate as she cares for her husband who suffers with ill health so she did not want to go into hospital.

The Community IV Nurses visited Josephine twice a day for two days to administer the drug Furosemide and assess her condition. Results were regularly scanned and fed back to the consultant and staff from the team spoke with him regularly through the two days.

After two days Josephine’s treatment was completed and her blood pressure and swelling reduced significantly.

Josephine said:

“The service has been marvellous. The nurses and Dr Farag were lovely and explained everything to me. I didn’t want to go into hospital so it was nice to be able to stay out of hospital and be treated. It really helped my recovery being at home. “

Rebecca Redfern added:

“The trial has been really successful and we are currently looking to identify other suitable patients with heart failure as test cases for the innovative trial. If successful, we have the potential to treat more patients in their own homes where they are most comfortable and reduce pressure on our local hospitals.“

Dr Farag said:

“I was extremely delighted with the outcome in Mrs Creaghan’s case. The communication with the Community IV Team, their professionalism and excellent service, meant that we avoided hospital admission altogether for Josephine.

“We know that every day the patient spends in hospital results in a significant loss of muscle mass, mobility and independence. So by treating the patient at home, we are not only preventing a hospital admission but also preserving the patient’s functional status and existing support for as long as needed. This model has been successful in other areas of the country and I am keen for our Warrington and Halton patients to benefit from this treatment pathway as well.”

To find out more about Warrington’s Community IV Service visit www.bridgewater.nhs.uk/warrington/ivtherapy.


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