PD519 - PATIENTS ADHERENCE TO PRESCRIBED HPN TREATMENT

PD519

PATIENTS ADHERENCE TO PRESCRIBED HPN TREATMENT

M. Hellerman Ithaki¹ on behalf of Moran Hellerman Ithaki, MD, Ilya Kagan, MD, Neta Tamman, RN, Pierre Singer, MD., A. R. Lester² on behalf of Anna Lester, MSc, Talia Harouche, BSc, Karin Last, BSc, P. Singer^3,* on behalf of Moran Hellerman Ithaki, MD, Ilya Kagan, MD, Neta Tamman, RN, Pierre Singer, MD.

¹ICU, Rabin Medical Center, Petach Tikvah, ²Clinical Affairs, Eitan Medical, Netanya, ³Rabin Medical Center, Beilison Hospital, Tel aviv, Israel

Rationale: This study quantified adherence to prescribed Home Parenteral Nutrition (HPN) regimens using objective infusion pump data1 and to assess discrepancies between prescribed and actual administration. Nonadherence, a multi-factorial concern, is a challenge that complicates the clinician's ability to accurately assess and make appropriate adjustments to therapy and may increase the risk of complications.

Methods: Ethics approval was obtained from Rabin Medical Center. Adult HPN patients (≥18 years) receiving home TPN via the Sapphire™ infusion pump for >6 months were recruited during follow-up visits (telemedicine or in person). Sixteen patients consented to retrospective analysis. Pump data was transmitted from Sapphire Connect for a minimum of 3 months’ continuous infusion. Adherence was analyzed across volume, duration, and frequency as ratios of prescribed therapy (1 = perfect adherence; <1 under-adherence; >1 over-administration).

Results: Of 16 recruited patients, 3 withdrew and 2 excluded due to insufficient data, leaving 11 patients (6 female, 5 male; median age 59 [IQR 45–79]). Patients received HPN for a median of 2 years (IQR 1–3). Volume (median 0.71 [IQR 0.60–0.99], p=0.024 and duration (median 0.77 [0.57–0.96], p=0.0009) were significantly non-adherent (Wilcoxon signed-rank test), while frequency (median 0.99 [0.78–1.18], p=0.966) did not differ significantly. One patient showed near-complete adherence, while another showed consistently poor adherence. Discordance between adherence measures was observed.

Conclusion: HPN adherence is variable, with significant under-delivery of volume and duration deviation despite preserved frequency. Pump data compared to prescription data presented in Eitan Insights, enables identification of drivers of non-adherence and supports targeted clinical interventions.

References: Hellerman Itzhaki M, Tamam N, Lester A, et al.(2024) Insights from home parenteral nutrition infusion data. Nutrition.doi:10.1016/j.nut.2023.112347

Disclosure of Interest: M. Hellerman Ithaki Grant / Research Support from: Eitan Medical sponsored the study. No other payments were received., A. Lester: None declared, P. Singer: None declared