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  1. Ribavirin therapy : implementation of hospital guidelines and effect on usage and cost of therapy.

    Article - En anglais

    Objective

    The American Academy of Pediatrics recommends that ribavirin be reserved for infants who are severely ill and who are at high risk of morbidity and mortality, based on underlying clinical conditions.

    The purpose of this study was to evaluate current ribavirin use in our institution, implement hospital-specific guidelines for use, develop a prospective surveillance system to monitor ribavirin therapy, evaluate the impact of these guidelines on subsequent use and cost of therapy.

    Methods

    Ribavirin use was compared with the recommendations of the AAP.

    Results were presented to the professional staff, and hospital guidelines were implemented.

    Ribavirin therapy was reevaluated in a 2-year period after hospital guidelines were implemented.

    Results

    In the initial evaluation period, only 67% of the ribavirin recipients met the AAP guidelines for use, and 19% received an inappropriate treatment regimen.

    The total cost and billed patient charges for ribavirin recipients who did not meet the guidelines for use in period 1 was $60 638 and $127 940, respectively.

    Conclusions

    Before the implementation of hospital guidelines for use, a substantial percent of patients received ribavirin not consistent with the recommendations of the AAP.

    Following the adoption of a modified version of the AAP guidelines for our institution and the use of a multidisciplinary surveillance system for monitoring ribavirin therapy, we observed a substantial decrease in the overall ribavirin use.

    Mots-clés Pascal : Pneumopathie, Enfant, Homme, Nourrisson, Bronchite, Virose, Infection, Aigu, Virus respiratoire syncytial humain, Pneumovirus, Paramyxoviridae, Virus, Traitement, Chimiothérapie, Ribavirine, Antiviral, Milieu hospitalier, Evaluation, Indication, Analyse coût, Economie santé, Recommandation, Poumon pathologie, Appareil respiratoire pathologie, Bronche pathologie

    Mots-clés Pascal anglais : Pneumopathy, Child, Human, Infant, Bronchitis, Viral disease, Infection, Acute, Human respiratory syncytial virus, Pneumovirus, Paramyxoviridae, Virus, Treatment, Chemotherapy, Antiviral, Hospital environment, Evaluation, Indication, Cost analysis, Health economy, Recommendation, Lung disease, Respiratory disease, Bronchus disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0413110

    Code Inist : 002B02S05. Création : 01/03/1996.