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Comparative Study
. 2012;6(1):e28-34.
Epub 2012 Mar 13.

Appropriateness of the Use of Intravenous Immune Globulin Before and After the Introduction of a Utilization Control Program

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Free PMC article
Comparative Study

Appropriateness of the Use of Intravenous Immune Globulin Before and After the Introduction of a Utilization Control Program

Thomas E Feasby et al. Open Med. .
Free PMC article

Abstract

Background: Intravenous immune globulin (IVIG) is an expensive and sometimes scarce blood product that carries some risk. It may often be used inappropriately. We evaluated the appropriateness of IVIG use before and after the introduction of an utilization control program to reduce inappropriate use.

Methods: We used the RAND/UCLA Appropriateness Method to measure the appropriateness of IVIG use in the province of British Columbia (BC) in 2001 and 2003, before and after the introduction of a utilization control program designed to reduce inappropriate use. For comparison, we measured the appropriateness of use during the same periods in the province of Alberta, which had no control program.

Results: Of 2256 instances of IVIG use, 54.1% were deemed to be appropriate, 17.4% were of uncertain benefit, and 28.5% were deemed inappropriate. The frequency of inappropriate use in BC after the introduction of the utilization control program did not differ significantly from the frequency before the program or the frequency in Alberta.

Interpretation: Almost half of IVIG use in BC and Alberta was judged to be inappropriate or of uncertain benefit, and the frequency of inappropriate use did not decrease after implementation of a utilization control program in BC. More effective utilization controls are necessary to prevent wasted resources and unnecessary risk to patients.

Conflict of interest statement

Competing interests: None declared.

Figures

Table 1
Table 1
Number of scenarios developed for assessing the appropriateness of intravenous immune globulin (IVIG) use appropriateness, inappropriateness and uncertainty
Table 2
Table 2
Characteristics of new patients who received intravenous immune globulin
Table 3
Table 3
Appropriateness of intravenous immune globulin use in new patients, by diagnostic category
Table 4
Table 4
Appropriateness of intravenous immune globulin use in new patients, by intervention group

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