Evaluating the effectiveness of clinical pharmacist supervision over protocol-based IVIG administration in a...

Intravenous immunoglobulin (IVIG) is a high-cost therapy that is widely used in paediatric care for its immunomodulatory effects. However, inappropriate prescribing contributes to resource waste and potential harm. This study aimed to evaluate the impact of clinical pharmacist-led supervision on the rational use of IVIG in a paediatric hospital setting.

A retrospective cross-sectional study was conducted at a paediatric hospital, comparing two 6 month periods: before and after the implementation of a clinical pharmacist-driven prescribing protocol. A total of 248 paediatric patients were systematically selected and assessed for IVIG indication appropriateness, dosing accuracy, and corticosteroid pre-treatment. Statistical analyses were performed to compare clinical variables across the two periods.

Following clinical pharmacist intervention, the proportion of appropriate IVIG prescriptions significantly increased from 49.2% to 66.9% (p<0.001), and the number of vials used decreased from 837 to 451. Dosing improvements led to the saving of 199 vials, equating to approximately £15,694 in cost savings. Among patients with immune thrombocytopenic purpura (ITP), the rate of corticosteroid use, as the first-line therapy prior to IVIG administration, increased from 10.5 to 33.3%. Although IVIG use increased in certain departments, its administration became more evidence-based and targeted to appropriate indications.

Clinical pharmacist-led supervision significantly improved the appropriateness of IVIG use in paediatric patients, reduced unnecessary dosing, and contributed to substantial cost savings, underscoring the critical role of clinical pharmacists in optimising high-cost medication use. Further prospective studies are recommended to assess long-term clinical outcomes of such interventions.