Parenteral Nutrition (TPN) at Home

Enteral nutrition uses the gastrointestinal tract: oral diet, liquid nutritional supplements, or tube feeding. It is preferred whenever the gut can be used safely.

Parenteral nutrition is used when the gastrointestinal tract cannot be used safely, or cannot absorb enough to meet the patient's caloric and nutritional requirements. It also maintains hydration.

The prescriber determines whether parenteral nutrition is indicated. Conditions in which it is used include:

• bowel obstruction
• short bowel syndrome
• Crohn's disease and ulcerative colitis
• certain cancers

The prescriber also determines the composition, volume and method of administration for each patient.

1. The prescriber's office sends a referral by phone or fax; the numbers are in the key facts below.
2. MedRx's intake team verifies insurance benefits and obtains prior authorization when the plan requires it.
3. MedRx prepares the TPN to the prescriber's order.
4. The TPN and supplies, including tubing and an infusion pump, are delivered to the patient's door at no charge. Next-day delivery is available; timing varies by location.
5. A skilled, trusted and licensed nurse from an accredited nursing agency maintains the IV line, such as a PICC line, draws blood for the laboratory tests the prescriber orders, and trains the patient or caregiver to administer the TPN.
6. A MedRx pharmacist is available 24 hours a day, 7 days a week.

Many patients on parenteral nutrition work, attend school and remain active. This depends on the severity of the underlying condition and the patient's symptoms, and is assessed with the prescriber.

MedRx's intake team verifies coverage and secures any required authorization before the first delivery. Medicare coverage of home infusion therapy depends on the therapy, the plan and the patient's clinical need. Where out-of-pocket costs are a barrier, MedRx helps patients find and apply for copay assistance, grants and other financial aid.