Feasby Thomas E, Quan Hude, Tubman Michelle, Pi David, Tinmouth Alan, So Lawrence, Ghali William A
Faculty of Medicine, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta.
Open Med. 2012;6(1):e28-34. Epub 2012 Mar 13.
Intravenous immune globulin (IVIG) is an expensive and sometimes scarce blood product that carries some risk. It may often be used inappropriately. We evaluated the appropriateness of IVIG use before and after the introduction of an utilization control program to reduce inappropriate use.
We used the RAND/UCLA Appropriateness Method to measure the appropriateness of IVIG use in the province of British Columbia (BC) in 2001 and 2003, before and after the introduction of a utilization control program designed to reduce inappropriate use. For comparison, we measured the appropriateness of use during the same periods in the province of Alberta, which had no control program.
Of 2256 instances of IVIG use, 54.1% were deemed to be appropriate, 17.4% were of uncertain benefit, and 28.5% were deemed inappropriate. The frequency of inappropriate use in BC after the introduction of the utilization control program did not differ significantly from the frequency before the program or the frequency in Alberta.
Almost half of IVIG use in BC and Alberta was judged to be inappropriate or of uncertain benefit, and the frequency of inappropriate use did not decrease after implementation of a utilization control program in BC. More effective utilization controls are necessary to prevent wasted resources and unnecessary risk to patients.
静脉注射免疫球蛋白（IVIG）是一种昂贵且有时稀缺的血液制品，存在一定风险。它可能经常被不恰当地使用。我们评估了在引入一项旨在减少不当使用的使用控制计划前后IVIG使用的合理性。
我们采用兰德/加州大学洛杉矶分校合理性方法，在2001年和2003年对不列颠哥伦比亚省（BC）在引入旨在减少不当使用的使用控制计划前后IVIG使用的合理性进行了测量。为作比较，我们测量了同期没有控制计划的艾伯塔省的使用合理性。
在2256例IVIG使用实例中，54.1%被认为是合理的，17.4%的益处不确定，28.5%被认为是不合理的。引入使用控制计划后，BC省不当使用的频率与计划实施前或艾伯塔省的频率相比，没有显著差异。
BC省和艾伯塔省近一半的IVIG使用被判定为不合理或益处不确定，且BC省实施使用控制计划后，不当使用的频率并未降低。需要更有效的使用控制措施，以防止资源浪费和对患者造成不必要的风险。
