Evaluation of rational prescription pattern of intravenous immunoglobulin (IVIG) based on FDA-approved indications among teaching hospitals in Birjand

Background and Aims: Intravenous immunoglobulin (IVIG) is one of the safest biological products, which is effective in the treatment of many diseases. This study aimed to evaluate the rational prescription pattern of IVIG based on the approved indications of the Food and Drug Administration (FDA) among teaching hospitals in Birjand, Iran. Materials and Methods: This descriptive-analytical study included 300 patients receiving IVIG who were hospitalized in different wards of Razi and Vali-e-Asr hospitals in Birjand during 2016-19. Demographic characteristics, dose, duration of administration, duration of hospitalization, side effects, and other necessary information were extracted from patients' medical records. The collected data were compared with FDA-approved indications and dosages, followed by identifying the rate of rational prescription of the drug. The data were analyzed in SPSS software (version 19) through independent t-test (or Mann-Whitney) and Chi-square test to compare quantitative and qualitative variables in the groups, respectively. Results: According to the results, half of the patients were male (n=150; 150%). The mean age of the patients receiving IVIG was 28.17±27.01 years. Most of the patients receiving IVIG (30.3%) were hospitalized in the neurology ward. Guillain-Barre syndrome and immune thrombocytopenic purpura accounted for the most prescription of IVIG. In total, 133 patients (44.3%) (95%CI: 38.6-50.1) received the drug according to the FDA on-labeled indication. The dose of IVIG was rationally based on FDA in 33% of the cases (95%CI: 27.7-38.6). Conclusion: Due to the limited availability and high price of this product, it is recommended to formulate and closely monitor the implementation of rational IVIG consumption in the hospital based on the regional standard protocol, especially with the presence of clinical pharmacists.