Improving the prescribing of palivizumab

Trist, S; Horsley, E; Katf, H; Tasker, N; Mostaghim, M

Improving the prescribing of palivizumab

Trist, S Horsley, E Katf, H Tasker, N Mostaghim, M

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Publication Type:: Journal Article
Citation:: Journal of Paediatrics and Child Health, 2018, 54 (12), pp. 1353 - 1356
Issue Date:: 2018-12-01

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Field	Value	Language
dc.contributor.author	Trist, S	en_US
dc.contributor.author	Horsley, E	en_US
dc.contributor.author	Katf, H	en_US
dc.contributor.author	Tasker, N	en_US
dc.contributor.author	Mostaghim, M https://orcid.org/0000-0001-9918-7765	en_US
dc.date.available	2018-05-08	en_US
dc.date.issued	2018-12-01	en_US
dc.identifier.citation	Journal of Paediatrics and Child Health, 2018, 54 (12), pp. 1353 - 1356	en_US
dc.identifier.issn	1034-4810	en_US
dc.identifier.uri	http://hdl.handle.net/10453/132889
dc.description.abstract	© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Palivizumab prevents respiratory syncytial virus (RSV) in children at high risk of severe disease. This paper reviews the use and effectiveness of palivizumab at two tertiary paediatric hospitals (hospitals A and B) in New South Wales, Australia. Methods: Children prescribed palivizumab during the pre-intervention period, 1 January 2013 until 31 December 2014, were compared with children under 2 years of age who were admitted to paediatric intensive care units (PICUs) with an RSV infection. Eligibility for palivizumab was determined. To improve evidence-based utilisation of palivizumab, a ‘streamlined palivizumab individual patient use’ (IPU) pro forma was introduced at hospital A during 2015, and its applicability was reviewed. Results: In the 2 years prior to implementing the streamlined IPU, 47 children received palivizumab, with 87% at hospital A. Of the children at hospital A, 32% did not meet the guidelines, and 32% did not complete the course. While 13% of children admitted to PICU for RSV infection were eligible for palivizumab, none received it prior to admission. In 2015, 16 streamlined IPUs were submitted, and 11 patients received palivizumab. Of these patients, 27% did not meet the guidelines, and 63% did not complete the course. Of the children who received palivizumab during the three RSV seasons, one developed an RSV infection, and none were admitted to PICU. Conclusions: Palivizumab is often prescribed without meeting recognised best practice guidelines, and patients eligible are frequently not prescribed palivizumab. The streamlined IPU, implemented in hospital A, excluded patients who did not meet guidelines. The pro forma needs further refinement, and complementary strategies introduced to improve compliance.	en_US
dc.relation.ispartof	Journal of Paediatrics and Child Health	en_US
dc.relation.isbasedon	10.1111/jpc.14083	en_US
dc.subject.classification	Pediatrics	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Respiratory Syncytial Virus Infections	en_US
dc.subject.mesh	Antiviral Agents	en_US
dc.subject.mesh	Treatment Outcome	en_US
dc.subject.mesh	Pediatrics	en_US
dc.subject.mesh	Neonatology	en_US
dc.subject.mesh	Intensive Care Units, Pediatric	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Drug Prescriptions	en_US
dc.subject.mesh	Quality Improvement	en_US
dc.subject.mesh	Palivizumab	en_US
dc.title	Improving the prescribing of palivizumab	en_US
dc.type	Journal Article
utslib.citation.volume	12	en_US
utslib.citation.volume	54	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Students
utslib.copyright.status	closed_access
pubs.issue	12	en_US
pubs.publication-status	Published	en_US
pubs.volume	54	en_US

Abstract:

© 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians) Aim: Palivizumab prevents respiratory syncytial virus (RSV) in children at high risk of severe disease. This paper reviews the use and effectiveness of palivizumab at two tertiary paediatric hospitals (hospitals A and B) in New South Wales, Australia. Methods: Children prescribed palivizumab during the pre-intervention period, 1 January 2013 until 31 December 2014, were compared with children under 2 years of age who were admitted to paediatric intensive care units (PICUs) with an RSV infection. Eligibility for palivizumab was determined. To improve evidence-based utilisation of palivizumab, a ‘streamlined palivizumab individual patient use’ (IPU) pro forma was introduced at hospital A during 2015, and its applicability was reviewed. Results: In the 2 years prior to implementing the streamlined IPU, 47 children received palivizumab, with 87% at hospital A. Of the children at hospital A, 32% did not meet the guidelines, and 32% did not complete the course. While 13% of children admitted to PICU for RSV infection were eligible for palivizumab, none received it prior to admission. In 2015, 16 streamlined IPUs were submitted, and 11 patients received palivizumab. Of these patients, 27% did not meet the guidelines, and 63% did not complete the course. Of the children who received palivizumab during the three RSV seasons, one developed an RSV infection, and none were admitted to PICU. Conclusions: Palivizumab is often prescribed without meeting recognised best practice guidelines, and patients eligible are frequently not prescribed palivizumab. The streamlined IPU, implemented in hospital A, excluded patients who did not meet guidelines. The pro forma needs further refinement, and complementary strategies introduced to improve compliance.

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http://hdl.handle.net/10453/132889