Percutaneous endoscopic gastrostomy (PEG) is the preferred method for administering enteral nutrition in patients with a functioning gastrointestinal tract; however, gastrotomy feeding tubes (GFT) represent an adequate and cost-effective replacement that could be incorporated into the home healthcare system, according to the results of a study published in Digestive and Liver Disease.
A group of investigators from the Gastroenterology Unit of Imola Hospital, Bologna, Italy, conducted a study to assess the safety and cost-effectiveness of home GFT replacement. The study consisted of 235 GFT home replacements in 84 patients from July 2016 to December 2019. The median age of the study population was 79.5 (range, 74-94 years), and 34 (40.5%) were men. Indicators for enteral nutrition were dementia (n=40 [47.5%]), stroke (n=24 [28.3%]), coma and spinal injuries (n=13 [15.2%]), as well as neurodegenerative disorders (n=7 [9.1%]).
The researchers discovered that 230 (97.8%) procedures performed at the patient’s home were successful, and 5 patients were hospitalized because of lack of backflow of blue-colored solution to ensure correct GFT placement. The study authors reported that “no adverse events occurred.”
This study was limited by the absence of a control group of patients who could be treated in a hospital setting and possible deficiencies associated with the “sky blue method” to measure correct GFT placement. Nevertheless, it was determined that GFT replacement resulted in a cost reduction of 46.8%, which translated into €124 savings per procedure and approximately €29,000 savings for the total 42-month study period. These finding suggest that GFT replacement is a safe and cost-effective alternative to PEG for patients with a functioning gastrointestinal tract.
Cominardi, A, Lisotti, A, Teci E, Mangano, G, Fusaroli P. Elective home replacement of gastro feeding tubes is safe and cost-effective. Has hospital referral become obsolete? Dig Liver Dis. Published online December 28, 2020. doi:10.1016/j.dld.2020.12.004