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Impact of change in practice: pharmacist-led respiratory syncytial virus (RSV) immunoprophylaxis clinic
  1. T Vaghela,
  2. C Ramesh
  1. West Hertfordshire Hospitals NHS Trust, Hertfordshire, UK


Objective To measure the impact of a new Pharmacy-Led RSV immunoprophylaxis clinic on hospital admission rates in high-risk infants with RSV bronchiolitis.

Method Retrospective data was collected for all infants who attended the clinic from 2006/7 to 2009/10. Using a standardised form, clinic attendance, adverse events and hospital admission with respiratory syncytial virus (RSV) bronchiolitis during RSV season were documented. Preclinic data for the season 2004/5 and 2005/6 were collected along with adverse events and hospital admission with RSV bronchiolitis.

Results All infants received palivizumab in accordance with the local peri-natal network guidelines.1

Conclusion The results show that in the 4 years since the implementation of the clinic there have been no hospital admissions of high risk infants with RSV bronchiolitis. This is in contrast to the preclinic results where 5 out of 15 infants were admitted over a 2 year period. The reduction in the number of high risk infants admitted with RSV bronchiolitis following the introduction of the pharmacist-led clinic may be due to a number of factors. One major contributing factor is parental education. At the initial visit the pharmacist provides information on palivizumab, discusses the risk factors associated with development of severe RSV bronchiolitis and provides information on how to minimise these risk factors. Another contributing factor may have been a more accurate dosing of palivizumab at correct intervals. In the clinic the baby is weighed and then the pharmacist prescribes the accurate dose which is administered immediately by the nurse. In contrast to the pre clinic, at the clinic palivizumab was administered at regular 28 days intervals.

Additional benefits seen in the clinic have been a reduction in nursing time and a reduction in drug costs of palivizumab through efficient usage of the less expensive 100 mg vials. Experience and feedback from parents from the clinic over the last 4 years has shown that the parents value a specialist pharmacist advice in addition to nursing and medical advice.

This multidisciplinary clinic has been successful in delivering efficient immunoprophylaxis programme by providing a structured approach to the management of infants at high risk of developing severe RSV bronchiolitis. The pharmacy-led clinic has made an impact by demonstrating the value of a supplementary/independent-prescriber pharmacist in delivering improved patient care.

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