197  Window of opportunity to save cost, rationalise use and improve monitoring of IVIG: a tertiary-care-audit. Issue 6 (27th May 2022)

• Record Type: Journal Article
• Authors: Sherman, Danielle; Packwood, Shirley; Hewamadduma, Channa
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 6(2022)
• Page Start: A69
• Page End: A70
• Publication Date: 2022-05-27
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-ABN.226
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: IVIG is now widely used to treat immune-mediated neurological conditions with annual expenditure on IVIG within Neurosciences directorates exceeding several millions of pounds. IVIG use is strictly monitored by the Department of Health (DOH) due to its cost-burden and supply shortages. This audit evaluates large tertiary centre IVIG use in line with DOH guidelines. Methodology and Results: The paper and electronic records of the 57 patients receiving regular IVIG for a chronic neuromuscular condition were reviewed against the set criteria and standards. In the last year only: 79% of the patients had an annual review of IVIG therapy; 39% had ³1 clinical outcome measure checked to assess effectiveness of IVIG; and 37% of those classified as clinically stable/improved had an attempt at dose/frequency reduction of IVIG. This audit raised issues of requiring greater monitoring visits to ensure compliance and enforce trial of dose down-titration. Conclusion: Our data demonstrate a definite opportunity for optimisation of monitoring and rationalisa- tion of IVIG use in order to reduce the treatment burden on patients and reduce IVIG expenditure. To achieve these objectives and to increase efficient use of consultant clinics, a best practice algorithmic protocol driven by a nurse-led IVIG monitoring service is proposed. [e-mail]