{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:29:22Z","timestamp":1790256562761,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Intravenous immunoglobulin (IVIG) shortage represents an emerging issue in transfusion medicine. Limited data are available to determine effective strategies for optimal use. The objective of this retrospective observational study was to determine the impact of institutional measures on IVIG use at a large academic center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>IVIG infusions from November 26, 2018 to September 25, 2022 were categorized according to their appropriateness (Recommended, Option of treatment, or Unrecommended), based on provincial guidelines, and separated into three phases: Reference, Transition, and Post\u2010Implementation phases, the latter following the adoption of restrictive measures, including mandatory standardized order forms, a blood bank gatekeeping strategy, and the creation of a stewardship committee.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5431 IVIG infusions were administered to 544 patients, accounting for 295,033 g. The most common indication categories were neurology (30.4%), immunology (29.0%), and hematology (17.4%). From Reference to Post\u2010Implementation phase, IVIG infusions decreased from 2275 to 2000 with unrecommended indications dropping from 9.5% to 7.4% (<jats:italic>p<\/jats:italic>\u2009=\u20090.01), and a global reduction of 23.0% (from 131,163\u2009g to 100,936\u2009g of IVIG). Decrease in chronic immunomodulation accounted for 48.3% of total reduction (14,610\u2009g of 30,227\u2009g), whereas single\u2010use immunomodulation, 40.5% (12,237\u2009g of 30,227\u2009g). Moreover, an absolute reduction of 16.9% was observed in orders exceeding the recommended doses (20.8% to 3.9%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). Together, the unrecommended and excessive IVIG doses decreased from 19,975\u2009g (15.2%) to 6670\u2009g (6.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A global reduction in IVIG use and a preferential decrease in the unrecommended orders were observed, most likely attributable to the bundle of restrictive strategies implemented.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.18031","type":"journal-article","created":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T06:34:09Z","timestamp":1729233249000},"page":"2286-2295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The impact of institutional measures on optimal use of intravenous immunoglobulin"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6921-2018","authenticated-orcid":false,"given":"Jean\u2010Nicolas","family":"Champagne","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Desilets","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM)  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5501-1036","authenticated-orcid":false,"given":"Guillaume","family":"Roy","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oc\u00e9ane","family":"Landon\u2010Cardinal","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6256-0271","authenticated-orcid":false,"given":"Hugo","family":"Chapdelaine","sequence":"additional","affiliation":[{"name":"Division of Allergy and Clinical Immunology, Department of Medicine CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevi\u00e8ve","family":"Matte","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Laboratory Department CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Rioux\u2010Mass\u00e9","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM)  Montreal Quebec Canada"},{"name":"Department of Hematology and Transfusion Medicine CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Sophie","family":"Lemay","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM)  Montreal Quebec Canada"},{"name":"Department of Hematology and Transfusion Medicine CHUM  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"e_1_2_7_2_1","article-title":"Utilisation des immunoglobulines non sp\u00e9cifiques intraveineuses et sous\u2010cutan\u00e9es au Qu\u00e9bec 2019\u20132020","author":"Briand S","year":"2021","journal-title":"INSPQ"},{"key":"e_1_2_7_3_1","unstructured":"Hema\u2010Quebec.Every gesture counts. 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