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Media type:
E-Article
Title:
Using a standardised protocol was effective in reducing hospitalisation and treatment use in children with newly diagnosed immune thrombocytopenia
Contributor:
Labrosse, R;
Vincent, M;
Nguyen, U‐P;
Chartrand, C;
Di Liddo, L;
Pastore, Y
Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>Childhood immune thrombocytopenia (<jats:styled-content style="fixed-case">ITP</jats:styled-content>) has been associated with low bleeding rates and a high frequency of spontaneous remission. Although current guidelines suggest that most patients are just observed, children still receive platelet‐enhancing therapies for fear of bleeding complications. We hypothesised that a standardised protocol with a step‐down approach would reduce hospitalisation and treatment use.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A retrospective chart review was performed on patients diagnosed with acute <jats:styled-content style="fixed-case">ITP</jats:styled-content> between January 2010 and December 2014, before (n = 54) and after (n = 37) the standardised protocol, which was introduced in January 2013. Management and events during the first 3 months following diagnosis were recorded.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The protocol resulted in a 34% decrease in the hospitalisation rate (p < 0.001) at diagnosis. Prednisone treatment duration at diagnosis was also significantly reduced (13.1 versus 5.8 days, p = 0.004). Children over 3 years of age were 3.8 times less likely to be hospitalised (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.94–7.61) and 2.3 times less likely to receive treatment (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 1.2–4.3). There was no difference in the rate of persistent <jats:styled-content style="fixed-case">ITP</jats:styled-content> (38% versus 30%, p = 0.43) or serious bleeding complications (7% versus 5%, p = 0.70).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our <jats:styled-content style="fixed-case">ITP</jats:styled-content> management protocol significantly reduced hospitalisation rates and length of prednisone treatment without any increase in disease complications.</jats:p></jats:sec>