How in-home support reopened access to essential infusion therapy

When a patient’s survival depends on life-sustaining nutrition delivered through an IV, continuity of care is essential. For one patient, that continuity had broken down. After being labeled “non‑compliant” by multiple infusion providers, they were left with few options for ongoing therapy.

This story shows what can happen when pharmacy care teams slow down, listen closely and design care around the realities of a patient’s life — helping restore essential therapy through empathy and practical support.

In health care, the term “non‑compliant” is often used to describe a patient who misses appointments, has incomplete labs or struggles to consistently adhere to therapy. These surface-level behaviors can dramatically impact a person’s access to care, yet they rarely explain why care is breaking down.

One patient knows this experience all too well. After being labeled non-compliant, they were unable to secure support from several home infusion and home health organizations, keeping them from receiving the critical health care they needed.

Without a full understanding of the patient’s home environment, the focus stayed on what wasn’t happening rather than why. When Optum® Infusion Pharmacy became involved, the care team recognized the need for a different approach.

Instead of starting with past labels, Optum’s team started with the patient.

The team at Optum focused on understanding the patient’s day‑to‑day reality and building a care plan around their specific needs, with close collaboration across:

• Nursing 
• Nutrition 
• Pharmacy 
• Prescribing provider 
• Patient’s oncology clinic

A key part of that approach was the relationship that Andi, the patient’s Optum nutrition support dietitian, built through regular visits. Over time, she learned that missed doses and appointments were not about refusal nor lack of effort. The patient was often too sick to travel, struggling with persistent nausea and fatigue and managing care largely on their own.

As challenges became clearer, Andi raised concerns with the broader care team and pushed for in-home nursing care. Services like this weren't typically available in the area due to state-level limits on where in-home support can be offered. Working closely with one another, the team ultimately secured approval to bring Optum nurses into the home — a change that removed a major barrier to consistent care.
 

Once the care team entered the home, the picture became clear.

The patient was managing complex therapy without consistent access to basic equipment. Their housing instability added further challenges. None of these barriers were visible in the medical record, yet they directly affected the patient’s ability to meet care expectations.

With that context, Andi and the broader pharmacy team shifted to find more practical solutions, which included providing:

• A replacement IV pole to improve safety and independence
• An insulated cooler to protect medication during periods without refrigeration
• Transportation support coordinated through the oncology clinic when clinic visits were required

These were straightforward changes, but they made a meaningful difference because they were based on the patient’s reality.

Throughout this process, Andi remained a steady point of connection. She partnered with the pharmacy and the prescribing provider to adjust therapy when side effects interfered with use. She reinforced education around the importance of consistent adherence to therapy and created space for honest conversations. By listening first and maintaining regular touchpoints, Andi helped rebuild trust and reinforce that the patient wasn’t navigating care alone.

The patient has remained on therapy longer than they ever have with previous providers. Adherence isn’t perfect, and the team doesn’t expect it to be. What has changed is consistency. They’re better supported, more engaged in care and are no longer defined by a label.

When pharmacy care teams take time to understand the person behind the chart, they can address barriers rooted in access. By listening first, advocating within complex systems and building real relationships over time, it’s possible to create more stable outcomes for patients who might otherwise get left behind.

Guided by empathy and a deep understanding of patients’ lives, Optum Infusion Pharmacy adapts care to meet people where they are. It centers care around real people, making it easier to access and easier to navigate.