Bulletin 250407 — Immune Globulin Utilization Management Guidelines Update
New: Ontario Immune Globulin Utilization Management version 5 guidelines launched. Access updated tools and best practices.
To: Immune Globulin Ordering Clinicians
Category: Physician Services, Registered Nurse with Extended Class.
Written by: Drug Programs Policy and Strategy Branch, Health Programs and Delivery Division
Date issued: April 25, 2024
Bulletin Number: 250407
Overview
The Ministry of Health, in collaboration with the Ontario Regional Blood Coordinating Network (ORBCoN) and the Immune Globulin Advisory Panel (IGAP), is pleased to announce the launch of the new Ontario Immune Globulin Utilization Management (IGUM) guidelines, version 5.0. Key features include:
- an adjusted body weight Immune Globulin (IG) dose calculator
- revised medical condition categorization
- guidance on the evaluation of clinical effectiveness
- the use of alternatives
All ordering clinicians should adopt these updated best practices.
IG utilization best practices
IG use continues to rise across Canada at a rate of approximately 6-10% annually. For IG stewardship, it is crucial to follow these key recommendations when providing patient care.
IG should only be prescribed where there is evidence to support use, and
- Alternative therapies have failed or not feasible/available;
- IG dose is prescribed as per adjusted body weight calculator criteria;
- Use should be discontinued if benefit is not demonstrated;
- For continued use (i.e., maintenance therapy) the evaluation of clinical effectiveness must:
- Be performed 6 months after initiation of therapy and at minimum annually thereafter
- Include adjustment to the lowest effective dose and/or greatest treatment interval
- Consider trials of alternative therapies where appropriate
Key features of new guidelines
- Adjusted body weight IG dose calculator to be used in all patients meeting height and weight criteria.
- Color-coded categorization of medical conditions, including “Can be Used”, “Not for Routine Use” and “Do Not Use” categories.
- Revisions to the utilization categorization of previously noted medical conditions.
- Utilization guidelines for additional indications reflecting new therapies now in use and clarification of current conditions where IG may be used if alternatives have failed or are not available.
We appreciate the efforts of all clinicians in optimizing IG product utilization. Your role is crucial in ensuring the fiscal and product supply sustainability in Ontario.
We encourage you to adopt and train staff on the updated best practices and utilization guidelines outlined in the new IGUM version 5.0. Each clinician can contribute to system-wide optimization of IG product utilization.
Keywords/Tags
Immune Globulin; Immunoglobulin; Transfusion Medicine; Plasma Protein and Related Products; Utilization Management; IGUM; Best Practices; Clinical Guidelines.
Contact information
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