Cargando…

171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing

BACKGROUND: Serial monitoring of plasma cytomegalovirus (CMV) viral load monitoring with intervals of less than five days or using different assays for monitoring may cause unnecessary budgets for laboratory testing without changes in treatment, morbidity, and mortality. METHODS: The pre-interventio...

Descripción completa

Detalles Bibliográficos
Autores principales: Trirattanapikul, Akeatit, Pasomsub, Ekawat, Siriyotha, Sukanya, Pattanaprateep, Oraluck, Phuphuakrat, Angsana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752363/
http://dx.doi.org/10.1093/ofid/ofac492.249
_version_ 1784850703703867392
author Trirattanapikul, Akeatit
Pasomsub, Ekawat
Siriyotha, Sukanya
Pattanaprateep, Oraluck
Phuphuakrat, Angsana
author_facet Trirattanapikul, Akeatit
Pasomsub, Ekawat
Siriyotha, Sukanya
Pattanaprateep, Oraluck
Phuphuakrat, Angsana
author_sort Trirattanapikul, Akeatit
collection PubMed
description BACKGROUND: Serial monitoring of plasma cytomegalovirus (CMV) viral load monitoring with intervals of less than five days or using different assays for monitoring may cause unnecessary budgets for laboratory testing without changes in treatment, morbidity, and mortality. METHODS: The pre-intervention retrospective study and post-intervention prospective cohort study were performed. In 2021, the inpatient electronic pop-up and telephone interview and feedback were used to limit unnecessary plasma CMV viral load testing. The rate of plasma CMV viral load testing being performed with intervals of less than five days was compared before and after protocol implementation using the Poisson regression model. The cost-effectiveness of plasma CMV viral load testing after protocol implementation was also studied. RESULTS: After protocol implementation, there was a significant decrease in the rate of plasma CMV viral load test requests with intervals of less than five days from 11.8% to 6.2% [Incident rate ratio (IRR) 0.50, p-value < 0.001]. Of these, 38.9% was due to unintentional requests. After telephone interviews the rate of plasma CMV viral load test requests with intervals of less than five days decreased further to 4.7% (IRR 0.37, p-value < 0.001). The costs of plasma CMV viral load testing performed with intervals of less than five days and anti-CMV drugs were reduced significantly. (822,500 to 345,000 Thai Baht, p < 0.001 and 12,327,436 to 7,860,187 Thai Baht, p = 0.001) Incidence of plasma CMV viral load testing performed with intervals of less than five days [Figure: see text] Costs of plasma CMV viral load testing, anti-CMV drug, bronchoscopy, and gastrointestinal endoscopy [Figure: see text] CONCLUSION: The diagnostic stewardship program is helpful to reduce unnecessary plasma CMV viral load testing and costs without increasing CMV viremia and CMV diseases. This program should be maintained, and an electronic hard stop alert program should be developed. DISCLOSURES: All Authors: No reported disclosures.
format Online
Article
Text
id pubmed-9752363
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-97523632022-12-16 171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing Trirattanapikul, Akeatit Pasomsub, Ekawat Siriyotha, Sukanya Pattanaprateep, Oraluck Phuphuakrat, Angsana Open Forum Infect Dis Abstracts BACKGROUND: Serial monitoring of plasma cytomegalovirus (CMV) viral load monitoring with intervals of less than five days or using different assays for monitoring may cause unnecessary budgets for laboratory testing without changes in treatment, morbidity, and mortality. METHODS: The pre-intervention retrospective study and post-intervention prospective cohort study were performed. In 2021, the inpatient electronic pop-up and telephone interview and feedback were used to limit unnecessary plasma CMV viral load testing. The rate of plasma CMV viral load testing being performed with intervals of less than five days was compared before and after protocol implementation using the Poisson regression model. The cost-effectiveness of plasma CMV viral load testing after protocol implementation was also studied. RESULTS: After protocol implementation, there was a significant decrease in the rate of plasma CMV viral load test requests with intervals of less than five days from 11.8% to 6.2% [Incident rate ratio (IRR) 0.50, p-value < 0.001]. Of these, 38.9% was due to unintentional requests. After telephone interviews the rate of plasma CMV viral load test requests with intervals of less than five days decreased further to 4.7% (IRR 0.37, p-value < 0.001). The costs of plasma CMV viral load testing performed with intervals of less than five days and anti-CMV drugs were reduced significantly. (822,500 to 345,000 Thai Baht, p < 0.001 and 12,327,436 to 7,860,187 Thai Baht, p = 0.001) Incidence of plasma CMV viral load testing performed with intervals of less than five days [Figure: see text] Costs of plasma CMV viral load testing, anti-CMV drug, bronchoscopy, and gastrointestinal endoscopy [Figure: see text] CONCLUSION: The diagnostic stewardship program is helpful to reduce unnecessary plasma CMV viral load testing and costs without increasing CMV viremia and CMV diseases. This program should be maintained, and an electronic hard stop alert program should be developed. DISCLOSURES: All Authors: No reported disclosures. Oxford University Press 2022-12-15 /pmc/articles/PMC9752363/ http://dx.doi.org/10.1093/ofid/ofac492.249 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Trirattanapikul, Akeatit
Pasomsub, Ekawat
Siriyotha, Sukanya
Pattanaprateep, Oraluck
Phuphuakrat, Angsana
171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
title 171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
title_full 171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
title_fullStr 171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
title_full_unstemmed 171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
title_short 171. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
title_sort 171. diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9752363/
http://dx.doi.org/10.1093/ofid/ofac492.249
work_keys_str_mv AT trirattanapikulakeatit 171diagnosticstewardshiptolimitrepeatplasmacytomegalovirusviralloadtesting
AT pasomsubekawat 171diagnosticstewardshiptolimitrepeatplasmacytomegalovirusviralloadtesting
AT siriyothasukanya 171diagnosticstewardshiptolimitrepeatplasmacytomegalovirusviralloadtesting
AT pattanaprateeporaluck 171diagnosticstewardshiptolimitrepeatplasmacytomegalovirusviralloadtesting
AT phuphuakratangsana 171diagnosticstewardshiptolimitrepeatplasmacytomegalovirusviralloadtesting