Improving Palivizumab Compliance Through a Pharmacist-Managed RSV Prevention Clinic

Chow, Jennifer W; Chicella, Michael F.; Christensen, Anthony; Moneymaker, Carolyn S.; Harrington, John; Dice, James E.

doi:10.5863/1551-6776-22.5.338

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…Palivizumab prophylaxis has demonstrated great efficacy in reducing the morbidity of respiratory syncytial viral infections in infants with hemodynamically significant CHD, [13][14][15] yet studies suggest sub-optimal rates of administration to eligible infants, [16][17][18][19] and several studies highlight interventions to increase compliance. [20][21][22][23] Similarly, influenza vaccination reduces mortality in children with CHD, 24 yet only about half of children with high risk conditions such as cardiac disease receive it. 25 Measures to reduce hospital-acquired respiratory infection include hand hygiene, personal protective equipment when appropriate, patient cohorting in facilities with shared rooms, and judicious hospital visitor restrictions.…”

Section: Discussionmentioning

confidence: 99%

Acute respiratory infections in hospitalised infants with congenital heart disease

Ahuja

Mack

et al. 2020

Cardiol Young

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Objectives: To assess the overall burden and outcomes of acute respiratory infections in paediatric inpatients with congenital heart disease (CHD). Methods: This is a retrospective cross-sectional study of non-neonates <1 year with CHD in the Kid’s Inpatient Database from 2012. We compared demographics, clinical characteristics, cost, length of stay, and mortality rate for those with and without respiratory infections. We also compared those with respiratory infections who had critical CHD versus non-critical CHD. Multi-variable regression analyses were done to look for associations between respiratory infections and mortality, length of stay, and cost. Results: Of the 28,696 infants with CHD in our sample, 26% had respiratory infections. Respiratory infection-associated hospitalisations accounted for $440 million in costs (32%) for all CHD patients. After adjusting for confounders including severity, mortality was higher for those with respiratory infections (OR 1.5, p = 0.003), estimated mean length of stay was longer (14.7 versus 12.2 days, p < 0.001), and estimated mean costs were higher ($53,760 versus $46,526, p < 0.001). Compared to infants with respiratory infections and non-critical CHD, infants with respiratory infections and critical CHD had higher mortality (4.5 versus 2.3%, p < 0.001), longer mean length of stay (20.1 versus 15.5 days, p < 0.001), and higher mean costs ($94,284 versus $52,585, p < 0.001). Conclusion: Acute respiratory infections are a significant burden on infant inpatients with CHD and are associated with higher mortality, costs, and longer length of stay; particularly in those with critical CHD. Future interventions should focus on reducing the burden of respiratory infections in this population.

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Section: Discussionmentioning

confidence: 99%

Acute respiratory infections in hospitalised infants with congenital heart disease

Ahuja

Mack

et al. 2020

Cardiol Young

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Improvement in Palivizumab Administration Prior to Discharge for Hospitalized Infants with Hemodynamically Significant Congenital Heart Disease: A Quality Improvement Initiative

Jones

Campbell²,

Abernathy

et al. 2023

Pediatr Cardiol

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Evaluation of Appropriateness and Cost Savings of Pharmacist-Driven Palivizumab Ordering

Weaver¹,

Bondi²,

Shah³

et al. 2020

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES Guidelines by the AAP for the use of palivizumab prophylaxis for respiratory syncytial virus (RSV) recommend administration within 72 hours prior to discharge for selected high-risk patient populations. Our institution historically administered palivizumab on a fixed-day schedule of Mondays and Thursdays, but adjusted the practice in fall 2017 to a pharmacist-driven flex-schedule based on anticipated discharge date. This review evaluated the effect of pharmacist-driven palivizumab ordering on the appropriateness of palivizumab administrations, based on AAP and institutional recommendations. Additionally, this review evaluated for effects on institutional cost. METHODS This was a retrospective single-center evaluation including patients for whom palivizumab was ordered between July 1, 2016, and June 30, 2018. Patients in the 2016–2017 RSV season were in the fixed-day group, while patients in the 2017–2018 RSV season were in the flex-schedule group. RESULTS A total of 142 palivizumab doses were evaluated. Overall, 97% of administrations were for an appropriate indication. All doses administered inappropriately (n = 4) occurred in the fixed-day group. In the fixed-day group, 48.6% of doses were given within 72 hours prior to discharge, which increased to 70.1% in the flex-schedule group (p = 0.01). The amount of drug saved by batching was 1 vial for every 4.9 patients in the fixed-day group, and 1 vial for every 4.8 patients in the flex-schedule group. CONCLUSIONS There was a statistically significant improvement in compliance with AAP recommendations following the implementation of pharmacist-driven flex-schedule for palivizumab, compared to a fixed-day batching schedule. There was no significant difference in cost.

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Improving Palivizumab Compliance Through a Pharmacist-Managed RSV Prevention Clinic

Cited by 4 publications

References 26 publications

Acute respiratory infections in hospitalised infants with congenital heart disease

Acute respiratory infections in hospitalised infants with congenital heart disease

Improvement in Palivizumab Administration Prior to Discharge for Hospitalized Infants with Hemodynamically Significant Congenital Heart Disease: A Quality Improvement Initiative

Evaluation of Appropriateness and Cost Savings of Pharmacist-Driven Palivizumab Ordering

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