Transcript Paediatric Review March 2006

Streamlining requests for RSV
prophylaxis through the maze at
CHEO
Chuck Hui MD FRCPC
Paediatric Infectious Diseases
Assistant Professor of Paediatrics
SUMMARY OF CHANGES FOR THE
2010-2011 RSV PROPHYLAXIS SEASON
REVISED REQUEST PROCESS:
• Enrolment requests will continue to be evaluated by the ministry.
Initial dose requests can be processed by the ministry or by Abbott
Canada (Abbott). However all subsequent monthly dose/vial requests
must be faxed to Abbott for processing.
REVISED MINISTRY FORMS:
• Forms have been revised and enhanced with embedded tools to
support and facilitate the new request process
DOSE INTERVALS:
• A clinical or logistical rationale must be provided if intervals between
doses are too short – i.e. less than 21 days between the first and
second dose and less than 30 days for all subsequent doses
SEASON START:
• For eastern, central, and southern Ontario, the prophylaxis
season will start on or around November 1st
SEASON END:
• April 1st, 2011
• If requiring after April 1st, the requesting physician must
confirm to the ministry that the RSV season is continuing in
the patient’s area of residence by providing the date and
name of the health institution that was consulted
REVISED REQUEST PROCESS
• All enrolment requests must be faxed to the Ministry (416-326-1990
or 877-588-1658)
• INITIAL dose requests will be processed by the ministry if the 1st
row of the palivizumab supply request table on page 2 of the
enrolment/request form is completed and faxed at the same time as
the enrolment request
– Alternatively, the dose request can be submitted directly to Abbott by
faxing ONLY page 2 of the enrolment form or a multi-patient order
form.
• All other dose requests must be faxed to Abbott (800-513-7337) for
processing. Fax ONLY page 2 of the enrolment form or a multipatient order form for this purpose. Do not fax page 1 of the
enrolment form to Abbott – this page contains the patients personal
health information
REVISED MINISTRY FORMS
•
•
•
•
For the 2010-2011 RSV prophylaxis season, only the patient
enrolment/request form has been significantly revised.
The Risk Assessment Tool (RAT) and the multi-patient supply request forms
remain the same
Users can complete the forms online or download the forms in either PDF or
Microsoft Word format and save it to their local system for future use.
However, the forms will NOT save any information entered by a user. All recurring
information (e.g. physician information) must be re-entered when the file is reopened.
The links to the forms are available from the ministry’s program webpage:
(http://www.health.gov.on.ca//en/public/programs/drugs/funded_drug/fund_res
piratory.aspx) or from the Ontario Central Forms Repository
(http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf )
•
•
•
•
Enrolment/Request Form (form: 4645-87E)
Risk Assessment Tool (RAT) (form: 4646-87E)
Multi-Patient Palivizumab Supply Request and Dose Report (form: 4647-87E)
Multi-Patient Palivizumab Supply Request and Dose Report (Hospital Use Only)
2010-2011
2009-2010
What do you do?
• Individual office/clinic, palivizumab in your
clinic
– Fill out enrolment form
– Enroling and follow-up physician the same
– Fax 2nd page to Abbott
What do you do?
• NICU/Clinical areas
– Identify patients that qualify in a log book
• Send this information to CHEO RSV clinic
– If the patient is to be discharged home during
the season
• Fill out enrolment form
• Obtain the first dose and provide in NICU
• Send enrolment form to CHEO RSV clinic
CHEO RSV
Prophylaxis Program
Website: www.cheo.on.ca -> Professionals ->
Referring patients to CHEO -> RSV Prophylaxis
Email: [email protected]
Telephone: 613-737-7600 x2406
Fax: 613-738-4832
C1 clinic – start date November 5, 2010