Patient compliance with a home parenteral nutrition program

Area of Science:

• Clinical Nutrition
• Patient Care Management
• Home Healthcare

Background:

• Home parenteral nutrition (HPN) is a complex therapy for patients with chronic disabling diseases and malnutrition.
• Effective patient compliance is crucial for the safety and success of HPN at home.
• Assessing compliance requires a standardized and objective methodology.

Purpose of the Study:

• To systematically evaluate patient compliance with home parenteral nutrition (HPN).
• To identify factors influencing compliance levels in HPN patients.
• To assess the effectiveness of training and supervision in HPN management.

Main Methods:

• A systematic study involving an independent nurse assessing 10 HPN patients and families.
• Development and application of a compliance scale evaluating aseptic technique, procedure adherence, safety, equipment use, and complication knowledge.
• Data collection at varying time points post-HPN initiation.

Main Results:

• Patient compliance percentiles ranged from 73% to 97%, with a median of 95%.
• Seven out of 10 patients achieved overall compliance scores of 90% or higher.
• A notable deficiency was observed in patient knowledge regarding potential HPN complications.
• Positive correlations with high compliance included male sex, absence of children, and spousal support.

Conclusions:

• Patients with chronic disabling diseases and malnutrition can be safely managed at home with HPN.
• Proper patient training and ongoing supervision are essential for achieving high compliance.
• Addressing patient knowledge gaps, particularly concerning complications, is vital for optimizing HPN therapy.