Abstract
Background: Palivizumab is a monoclonal antibody for prevention of respiratory syncytial virus (RSV) infections, requiring therapeutic levels and a strict dosing schedule.
Objectives: To investigate adherence and its impact on outcomes.
Methods: Infants were enrolled into the Canadian RSV Evaluation Study of Palivizumab (CARESS) between 2005 and 2014. Monthly telephone interviews throughout the RSV season collected data on injection dates, respiratory illness related hospitalizations, and RSV testing. Statistical analyses identified differences between groups.
Results: 19198 infants received a total of 83244 injections in the 2005-2013 seasons. Adherence, receiving >=5 injections or 100% of expected injections within the appropriate intervals., occurred in 11691 infants (60.9%).Adherence was more likely (Exp(B) [95%CI], p-value) with higher maternal education (1.74 [1.50-2.03], <0.0005) and having siblings (1.07 [1.01-1.14], 0.03).Adherence was less likely in Aboriginals (0.48 [0.41-0.56], maternal smoking (0.78[0.71-0.86], <0.0005), and older infants (0.97 [0.94-0.99], 0.02)when adjusted for the significant demographic factors. Despite a non-significant association between compliance and RSVH (0.89 [0.68-1.16], 0.38), there was a significant difference (p<0.0005) in total duration of hospitalization between groups, with infants with acceptable adherence staying on average 7.79 ± 8.48 days and infants staying 16.64 ± 30.04 days.
Conclusions: Adherence to a palivizumab regimen is important. Poorer adherence affects health outcomes such as longer hospitalizations. Targeted interventions for families who have problems with adherence are needed to improve adherence to the palivizumab regimen.
- Copyright ©ERS 2015
