The Effects of Respiratory syncytial virus prophylaxis Application Protocol on Patient Compliance and Clinical Outcomes in Congenital Heart Diseases

Yıl 2019, , 201 - 204, 15.12.2019

Öykü Tosun

https://doi.org/10.16948/zktipb.495665

Öz

Introduction: Palivizumab
is a well tolerated, safe monoclonal antibody in the prevention of respiratuar
syncytial virus (RSV) in high-risk children. The adaptation of the parents is
extremely important for patients to be able to receive timely and full dose
prophylaxis. There are articles evaluating patient compliance and clinical
outcomes in RSV prophylaxis. Each clinic has its own follow-up and administration
protocol, but there are no studies on the protocols used, patient compliance
and dose completion.

Material
and Methods: A total of 60 patients with hemodynamically significant congenital heart
disease who had RSV prophylaxis in the pediatric cardiology outpatient clinic
between October 2016 and March 2018 were retrospectively reviewed. The patients
who received prophylaxis in 2 different seasons and were followed up with 2
different protocols were compared with each other in terms of compliance and
clinical results

Results: In the October 2016- March 2017 season, the mean dose was 1 ± 0.2 in
the 5-month period and full patient compliance was 10%. Dose intervals were
37.2 ± 6.15 days. 10 patients (40%) were hospitalized. After the protocol
change was made in the October 2017-March 2018 season, patient compliance was
evaluated as 100%

Conclusion: In palivizumab prophylaxis, increasing
the dose and increasing the compliance of the interval significantly decreases
hospitalizations due to RSV. Detailed and well-organized follow-up and
application protocols are extremely important in increasing compliance.

Anahtar Kelimeler

Respiratory syncytial virus, Congenital Heart Diseases, Compliance

Konjenital Kalp Hastalıklarında Respiratuar Sinsisyal Virus Proflaksisinde Uygulama Protokolünün Hasta Uyumu Üzerine Etkisi ve Klinik Sonuçları

Öz

Giriş: Palivizumab, yüksek riskli çocuklarda respiratuar
sinsisyal virüs (RSV) önlenmesinde iyi tolere edilen, güvenli bir monoklonal
antikordur. Hastaların zamanında ve tam doz proflaksi
alabilmeleri için anne ve babanın uyumu son derece önemlidir. RSV proflaksisinde hasta uyumunu ve klinik sonuçlarını değerlendiren
makaleler bulunmaktadır. Her kliniğin kendi takip ve uygulama protokolü
bulunmaktadır ancak kullanılan protokoller, hasta uyumu ve doz tamamlanması ile
ilgili bir çalışma bulunmamaktadır.

Hastalar ve Yöntem: Ekim 2016-Mart 2018
tarihleri arasında çocuk kardiyoloji polikliniğinde RSV proflaksisi endikasyonu
almış hemodinamik olarak anlamlı KKH’na sahip 2 yaş altı toplam 60 hastaya ait
veriler çocuk kardiyoloji poliklinik ve servis kayıtlarından retrospektif
olarak incelendi.  2 farklı sezonda, proflaksi endikasyonu alan
ve 2 farklı protokol ile takip edilen hastalar uyum ve klinik sonuçlar
açısından birbiriyle karşılaştırıldı. Tam uyum, sezon boyunca 5 aylık dönemde,
30 gün aralarla en az 4 doz palivizumab uygulaması yapılması olarak tanımlandı.

Bulgular:
Ekim 2016- Mart 2017 sezonunda, 5 aylık
dönemde uygulan ortalama doz 1 ± 0.2 doz idi ve tam hasta uyumu %10
olarak bulundu. Doz aralıkları 37.2 ± 6.15 gün olarak bulundu. 10 hastada (%
40) ASYE nedeniyle hastaneye yatış ve RSV izolasyonu mevcuttu. Ekim 2017-Mart
2018 sezonunda yapılan protokol değişikliği sonrası, hasta uyumu %100 olarak
değerlendirildi, ASYE nedeniyle acil servis başvurusu ve hastaneye yatış
gereksinimi tespit edilmedi.

Sonuç: Palivizumab
proflaksisinde doz tamamlanması ve aralığı uyumunu arttırmak RSV’ye bağlı
hastane yatışlarını önemli ölçülde azaltmaktadır. Detaylı ve iyi organize
edilmiş takip ve uygulama protokolleri hazırlanmak uyumu arttırmada son derece
önemlidir. 

Anahtar Kelimeler

Respiratuar Sinsisyal Virus, Konjenital Kalp Hastalıkları, , Uyum

Kaynakça

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