Evaluation of Intravenous immunoglobulin usage pattern in an educational hospital, a descriptive-cross sectional study, Bandar Abbas, IRAN

The goal of drug utilization evaluation (DUE) is to improve patients’ care. Studying the administration and utilization pattern of Intravenous Immunoglobulin (IVIg) is an important research topic due to its significant role in the treatment and control of many disorders, its high cost, and limited availability. We aimed to evaluate the pattern of IVIg use in an educational hospital. In this descriptive-cross sectional study, 250 patients’ records including medical orders, nursing notes and drug chart were evaluated. We used Food and Drug Administration (FDA) and United Kindom (UK) protocols to evaluate IVIg indications in our study. Data were analyzed using the SPSS software. Prescription of IVIg in our hospital adhered to FDA-approved and UK highly evidence based indications in 64.1% and 67.6% of the cases, respectively. Immune thrombocytopenic purpura (ITP) was the most common indication that IVIg was correctly prescribed for 52.7% based on FDA guideline and 50% based on UK guideline. Sepsis (15.5%), hyperbillirubinemia (10.4%), encephalitis (3.5%), and aplastic anemia (1.38%) were incorrect indications of IVIg in our study. Adverse drug reactions (ADRs) were observed in 14.5% of patients. Consumption of IVIg in our hospital, was more consistent with international guidelines compared to other hospitals in Iran, however unnecessary prescriptions cannot be ignored. We suggest developing national guidelines and educating our prescribers for the use of IVIg to minimize irrational prescription of expensive and important medicines such as IVIg.