{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:43:57Z","timestamp":1792158237910,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intravenous immunoglobulin (IVIG) treating secondary immunodeficiency (SID) for oncology patients causes strain for outpatient clinic capacity. Home\u2010based subcutaneous immunoglobulin (SCIG) offers equivalent efficacy and improves patient convenience and resource utilization. Transition to home\u2010based SCIG remains infrequent due to fragmented referral pathways, limited clinician awareness, and inconsistent patient education. The project objective was to increase the number of patients transitioning from IVIG to SCIG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A quality improvement initiative was established following a baseline assessment of the SCIG transition process and IVIG utilization patterns. A driver diagram informed change ideas tested across seven Plan\u2013Do\u2013Study\u2013Act (PDSA) cycles. The outcome measure was the monthly SCIG referral rate. The process measures were the median monthly number of chronic, new start, and total IVIG users in the outpatient clinic. The balancing measures assessed if SCIG referrals had an effect on chair time and operational costs. Electronic referral process was developed, clinician education enhanced, nurse champion role created, and clinician and patient education materials were standardized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following the intervention, the number of patients transitioning from IVIG to SCIG increased from 3.7% to 8.5%. The number of monthly new start IVIG users remained the same while the number of monthly chronic IVIG users increased. The balancing measures indicate that SCIG referrals did not reduce chair time but generated significant cost avoidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Transitions from IVIG to SCIG have shifted care into the home, reducing outpatient pressure and costs. Long\u2010term sustainability requires improved referral of chronic IVIG users and strategies to support patient engagement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70353","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:05:05Z","timestamp":1785495905000},"page":"1893-1901","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How do I transition oncology patients from intravenous immunoglobulin to subcutaneous immunoglobulin in an outpatient clinic?"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1548-8168","authenticated-orcid":false,"given":"Dior","family":"Caruso","sequence":"first","affiliation":[{"name":"Division of Medical Oncology and Haematology Princess Margaret Cancer Centre  Toronto Ontario Canada"},{"name":"Lawrence S. 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