PMID- 17958537
OWN - NLM
STAT- MEDLINE
DCOM- 20080107
LR  - 20220331
IS  - 0041-1132 (Print)
IS  - 0041-1132 (Linking)
VI  - 47
IP  - 11
DP  - 2007 Nov
TI  - Intravenous immunoglobulin utilization in the Canadian Atlantic provinces: a 
      report of the Atlantic Collaborative Intravenous Immune Globulin Utilization 
      Working Group.
PG  - 2072-80
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) use for labeled and unlabeled 
      indications is growing steadily. By use of a collaborative regional strategy, 
      baseline IVIG usage and appropriateness of utilization were determined for 
      Atlantic Canada. The effectiveness of strategies designed to optimize utilization 
      was also studied. STUDY DESIGN AND METHODS: A regional working group was created 
      to monitor IVIG utilization for a 2-year period in the four Canadian Atlantic 
      Provinces. A registry of IVIG was created. Assessment of indication 
      appropriateness was determined with national and provincial guidelines along with 
      expert clinical opinion. To optimize IVIG use, IVIG guidelines and feedback 
      reports were distributed to stakeholders. Appropriateness of IVIG use was 
      compared over the course of the study. RESULTS: The leading indications for IVIG 
      use were idiopathic thrombocytopenic purpura (17.3%), primary immune deficiency 
      conditions (14.9%), and chronic idiopathic demyelinating polyneuropathy (11.8%). 
      The leading prescribing specialists were neurologists (32.2%) and hematologists 
      (26.1%). A total of 37.1 percent of IVIG usage was in accordance with labeled 
      indications. After optimization strategies were implemented, there was little 
      change in labeled use. There was a 4.2 percent decrease in unlabeled use not 
      supported by evidence (p<0.001). CONCLUSIONS: A regional collaborative strategy 
      for monitoring IVIG use was established. Most of the IVIG use was for labeled or 
      appropriate indications. The majority of unlabeled use was supported by the 
      medical literature. Strategies to optimize IVIG utilization were associated with 
      a decrease in inappropriate IVIG use and a plateau in IVIG utilization compared 
      to the rest of the country.
FAU - Constantine, Maggie M
AU  - Constantine MM
AD  - Capital District Health Authority and the Nova Scotia Provincial Blood 
      Coordinating Program, Halifax, Nova Scotia, Canada.
FAU - Thomas, Wanda
AU  - Thomas W
FAU - Whitman, Lucinda
AU  - Whitman L
FAU - Kahwash, Eiad
AU  - Kahwash E
FAU - Dolan, Sean
AU  - Dolan S
FAU - Smith, Susan
AU  - Smith S
FAU - Caudle, Christopher J
AU  - Caudle CJ
FAU - Burton, Erica
AU  - Burton E
FAU - Anderson, David R
AU  - Anderson DR
CN  - Atlantic Collaborative Intravenous Immune Globulin Utilization Working Group
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transfusion
JT  - Transfusion
JID - 0417360
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Canada
MH  - Cooperative Behavior
MH  - Data Collection
MH  - Drug Labeling
MH  - *Drug Utilization Review
MH  - Hematologic Diseases/drug therapy
MH  - Humans
MH  - Immunoglobulins, Intravenous/economics/*therapeutic use
MH  - Polyradiculoneuropathy/drug therapy
MH  - Practice Guidelines as Topic
MH  - Purpura, Thrombocytopenic, Idiopathic/drug therapy
MH  - Registries
EDAT- 2007/10/26 09:00
MHDA- 2008/01/08 09:00
CRDT- 2007/10/26 09:00
PHST- 2007/10/26 09:00 [pubmed]
PHST- 2008/01/08 09:00 [medline]
PHST- 2007/10/26 09:00 [entrez]
AID - TRF01400 [pii]
AID - 10.1111/j.1537-2995.2007.01400.x [doi]
PST - ppublish
SO  - Transfusion. 2007 Nov;47(11):2072-80. doi: 10.1111/j.1537-2995.2007.01400.x.