Compliance with RSV prophylaxis: A comparison between office and home settings

Objective: To compare the efficacy of a home health care agency dosing-compliance program vs treatment in a private office setting during a single RSV season(11/05-04/06).

Methods: AAP guidelines were used to identify neonates eligible for RSV prophylaxis before discharge from NICU. Demographic data extracted included GA,BW,multiple births, #of siblings and daycare-enrollment. Unidentified home health care and Pediatrician's office records were reviewed for number and timing of Palivizumab doses received, RSV infection and hospitalization rates. Compliance data were calculated based on actual monthly injections given during the RSV season. Groups were compared using t-test and chi-square.

Results: Our study included 1,362 infants who received Palivizumab during a single RSV season from 11/05-04/06. Of these infants, 350(26%) were <28wks, 393(29%) were 28-31wks, 424(31%) were 32-35wks, and 195(14%) were>35 wks. 618 infants (45%) received their monthly injections in the home setting where 95% of the doses were given on schedule. In contrast, 676 infants (55%) received their monthly injections in the office setting with a compliance rate of 91% (p< 0.001). There were 16 hospitalizations in the office setting group with 5 cases due to RSV infection compared to 1 SVT and 1 RSV admission reported in the home setting group.(p<.01)

Conclusion: Infants receiving Palivizumab at home are still more likely to receive all scheduled doses on time. There is significantly less RSV hospitalization in infants who received RSV immunoprophylaxis at home. These results have been consistent with our previous data analysis for the past 6 RSV seasons.