Indications that were categorized under ‘future research’ represented 6.1% of the total average annual use within the pediatric and adult populations. These patients may have ben’ efited from IVIG therapy, but additional research is required to validate its use. ventolin inhalers
Specialist use of IVIG
In adults, hematologists and neurologists by far were the two most prevalent prescribers of IVIG across all three assessment years (Figure 3). This information was not available from the pediatric blood bank databases.
Figure 3) Use patterns of intravenous immune globulin by physician specialty in adults between 1997 and 1999
The data from this study contain several limitations because the study was a retrospective audit, and technological limitations existed as a result of limited linkages between blood bank database systems and patient record database systems. Thus, some data could not be reconciled to diagnoses or reasons for IVIG use because it was not entered into the blood bank database. There was also a lack of standardization in data collection between the various blood banks, and there was no mandate to collect clinical outcomes. The 1999 neurology guidelines were used to assess usage in 1997 and 1998, and it should be noted that there may have been some neurological indications considered at that time: ‘future research’, which has subsequently been reclassified as ‘appropriate’ or ‘inappropriate’. However, even with such limitations, some clear trends about IVIG usage patterns and prescribers in Canada have emerged.