Document Detail


Respiratory syncytial virus morbidity and outpatient palivizumab dosing in South Carolina, 2004-2009.
MedLine Citation:
PMID:  22864095     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: Respiratory syncytial virus (RSV) has been identified as an important cause of lower respiratory tract disease in infants. In patients at high risk, prevention is attempted through immunoprophylaxis with palivizumab. In 2008, as a result of revisions to the American Academy of Pediatrics' guidelines, South Carolina Medicaid reduced the number of approved palivizumab doses from six to five. This study attempted to determine whether the reduction of approved doses would affect hospitalization and emergency department visits and to characterize dose administration.
METHODS: We obtained data for all South Carolina Medicaid reimbursed births from November 2004 through March 2009. For each RSV season, infants who should have received palivizumab were identified. Rates of outpatient palivizumab dosing and hospitalizations and emergency department visits because of RSV also were identified.
RESULTS: In the seasons sampled, 1956 infants met eligibility criteria for our study. Infants younger than 29 weeks' gestation received 34% to 48% of their total eligible palivizumab doses, whereas infants 29 to 31 weeks' gestation received 36% to 46% of their doses. The rate of emergency department visits and inpatient admissions because of RSV did not differ significantly across years.
DISCUSSION: In evaluating our primary outcome, there was no increase in hospitalizations or emergency department visits. Overall, we did note a poor dosing rate in all of the groups. A statistically significant decline in dosing per eligible month was noted following the dose reductions. Despite solid evidence of the benefits of palivizumab in high-risk groups, we are doing an inadequate job of dosing these patients.
CONCLUSIONS: We believe adherence to current recommendations for palivizumab dosing is suboptimal in preterm infants insured by the South Carolina Medicaid program. Healthcare professionals must work harder to identify and follow-up with patients who qualify for palivizumab dosing, including infants who meet criteria for a second season.
Authors:
Ashley D Chadha; Weichao Bao; Jeff Holloway; Joshua Mann; Anna K Rye; David E Brown
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Southern medical journal     Volume:  105     ISSN:  1541-8243     ISO Abbreviation:  South. Med. J.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404522     Medline TA:  South Med J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  399-404     Citation Subset:  AIM; IM    
Affiliation:
From the Palmetto Health University of South Carolina, the University of South Carolina Arnold School of Public Health, and the University of South Carolina School of Medicine.
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