Development, implementation and impact of an immunoglobulin stewardship programme in Saskatchewan, Canada

Author:

Sarker Kinsuk1,Vanstone Jason R.1ORCID,Adigun Oluwaferanmi1,Boutilier Brad2,Comeau Jessica3,Degelman Michelle L.1,Gottselig Paul1,Berry Warren E.1,Milne Ardyth4,Van Vliet Paula3,Harding Sheila Rutledge5

Affiliation:

1. Stewardship and Clinical Appropriateness Saskatchewan Health Authority Saskatoon Saskatchewan Canada

2. Strategy and Innovation Saskatchewan Health Authority Saskatoon Saskatchewan Canada

3. Transfusion Safety/Patient Blood Management Saskatchewan Health Authority Saskatoon Saskatchewan Canada

4. Rheumatology Consultant, Internal Medicine Saskatchewan Health Authority Saskatoon Saskatchewan Canada

5. Transfusion Medicine Consultant, Laboratory Medicine Saskatchewan Health Authority Saskatoon Saskatchewan Canada

Abstract

AbstractBackground and ObjectivesIntravenous immunoglobulin (IVIG) is one of the most costly and limited‐supply blood products. Judicious use of this therapy is important to ensure a continued supply is available for patients in need. The Saskatchewan IG Stewardship Program was initiated to monitor and reduce inappropriate IG use.Materials and MethodsThe Program was developed and implemented through the collaborative efforts of a multidisciplinary, inter‐organizational team. Funding was provided from provincial organizations to create new positions within the Program and to support stakeholder engagement throughout the process of implementation. Data were collected from local and national databases regarding the amount of IVIG used and appropriateness of orders based on published criteria.ResultsOver 20 months, the Program helped to reduce unnecessary IVIG use from pre‐intervention levels by more than 20%. Interventions from nurse navigators alone reduced inappropriate IVIG use by 2.6%. During the 20‐month period following Program initiation, more than 4 million CAD less was spent on IVIG compared with the previous 20 months.ConclusionThe Saskatchewan IG Stewardship Program has led to more appropriate IVIG use across the province, more effective preservation of this limited healthcare resource, and cost savings that more than cover the cost of administering the Program.

Publisher

Wiley

Subject

Hematology,General Medicine

Reference20 articles.

1. Clinical uses of intravenous immunoglobulin

2. Government of Canada.Protecting access to immune globulins for Canadians: final report of the expert panel on immune globulin product supply and related impacts in Canada.2018. Available from:https://publications.gc.ca/site/eng/9.854785/publication.html. Last accessed 12 Nov 2023.

3. Sask Blood.Saskatchewan immune globulin Stewardship Program. SaskBlood.2015. Available from:https://saskblood.ca/programs/sk-ivig-program/. Last accessed 29 Jul 2023.

4. Unlabeled uses of intravenous immune globulin

5. Appropriateness of the use of intravenous immune globulin before and after the introduction of a utilization control program;Feasby TE;Open Med Peer‐Rev Indep Open‐Access J,2012

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