The Netherlands Marianne van der Ent Jolanda van Esch Riet Strik Albers Dutch Nursing group for Immunodeficiency (LW-VID)

Practice in the Netherlands Estimated about 8500 patients (adults and children) with PID (16 million inhabitants). 60% of them have primary antibody deficiency. At this moment about 1000 patients with immunoglobulin-substitution. 20% SCIG 80% IVIG

Our role as nurse practitioner Informing patients about:  His/her PID / lifestyle / traveling etc.  Treatment options: SCIG versus IVIG.  Home therapy versus hospital based therapy (difference between the hospitals).  Sometimes there is an indication why a patient can not be treated at home.

Home therapy (teamwork) SCIG /HyQvia  Patient / partner / parent on self infusion  Training in the hospital.  Training by the homecare nurse. IVIG Monitoring (sometimes during whole session) by homecare nurse. (Self infusion sometimes by partner / parent). 2 times on daycare, after that home therapy Samples for IgG through levels can be taken at home. Back-up is always possible in case of adverse events. Patient got instructions when and how to take rescue medication.

Equipment and costs  All equipment (pumps-needles-tubes-lines etc) is provided and delivered at home.  Medication is delivered at home.  Trained homecare nurses go to the patient.  All costs are taken care of by the health insurance company.  Adults pay a low contribution (eigen bijdrage) per year ( 360 euro) children are for free.