Young patients who are not able to obtain proper nutrition orally are continuing to benefit from the Home Total Parenteral Nutrition (HPN) service that was first introduced at Hamad Medical Corporation (HMC) in 2011.
Total Parenteral Nutrition (TPN) prevents malnutrition in patients with intestinal function failure and provides liquid nutrients, including carbohydrates, proteins, fats, vitamins and minerals, through the vein.
The service is typically prescribed for patients who are not able to properly absorb the nutrients in food, a condition that can be caused by reduced length of the bowel (Short Bowel Syndrome), a disorder affecting the intestinal cells responsible for food absorption.
In 2011, HMC implemented the HPN service, which is the only such program in the Arab region, and allows patients to receive the TPN service at home.
Dr. Kamal Osman Hassan, Pediatric Gastroenterology Senior Consultant at Hamad General Hospital, said that since the service was implemented, ten patients have benefited and no longer require lengthy hospital stays. He added that this number is continuing to grow with three more patients currently undergoing training in preparation for discharge on HPN.
“With the HPN service, our patients now stay at home with their families and enjoy the life that other children have. They can go to school, shopping, outdoor parks and travel with their families; things that were very difficult before the service was introduced,” saidDr. Hassan.
Parents of the patients who use the service have praised HPNand the clinical team that manages the service at HMC, saying it has truly given their child, and their entire family, a new lease on life. “During the time we needed to stay at the hospital it was very hard because of our commitments with work and our other children. We are much relieved with the home service,” said one of the parents whose child is benefiting from HPN.
Each child’s situation is different and the amount of time spent connected to HPN varies but both doctors and patients’ families admitted that the long stay in hospital required to administer the service adversely affected the child’s quality of life. “Children who came for intravenous nutrition at an early stage in their lives showed very slow development compared to other children of their age,” stated Dr. Hassan.
Ms. Salma Al Marri, the mother of a young patient, Mayassa, who is now a lively nine-year-old, said that before Mayassa was placed under the Home TPN Services he had to stay in the hospital for four years.
“The HPN is an excellent service that has truly helped us; because of this service, I no longer have to come to the hospital every day to watch over Mayassa. We just have to come three times a week to pick up the TPN bag, and every month for her medication.”
Ms. Al Marri added: “Mayassa is a sociable child and having her at home has enabled her to do the things she enjoys, such as visiting friends and relatives and traveling. She is no longer stuck in the hospital as she was before we availed of the Home TPN.”
Prior to transitioning to theHPNprogram, both parents and the young patients areprovided with training explaining how to administerand connect the parenteral nutrition bag to the intravenous catheter and how to clean it. Nurses from HMC’s home healthcare service visit the patients in their homes regularly (usually once per week), to perform checkups and provide additional medical assistance. HMC provides patients with all required equipment for the HPN program.
Dr. Hassansaid the service has resulted in a significant reduction in the rate of infection and TPN complications, reducing the need to send patients abroad for bowel rehabilitation and/or small bowel transplantation.
“The success of the program has been amazing. As a direct result of the program,we have seen a reduced need to send patients abroad for bowel rehabilitation and/or small bowel transplantation. In the five years prior to starting the program, 14 intestinal-failure patients travelled abroad to undergo small bowel transplantation. Since the program has been offered at HMC, none of the ten patients enrolled have had to travel abroad,” added Dr. Hassan.
He added the benefits of the program go beyond the patients enrolled in the service by freeing up inpatient beds and decompressing the pediatric inpatient ward.
“Not only does this new system provide patients and their families with a greater opportunity to live their lives like any other family, it allows us to provide beds to other patients that were once occupied for years by patients needing parenteral nutrition,” noted Dr. Hassan.
“I would like to take this opportunity to thank all the parents of the children enrolled in the HPN program for their great courage taking this huge responsibly. They are the true heroes of this program and without their dedication and commitment, such a great success could never have been achieved,” added Dr. Hassan.
Last year, the HPN service was recognized at HMC’s Stars of Excellence (SOE) Award under the Patient Experience category.