Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
2
Issued Date
2023-06-09
Resource Type
eISSN
14712334
Scopus ID
2-s2.0-85161650125
Pubmed ID
37296377
Journal Title
BMC infectious diseases
Volume
23
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC infectious diseases Vol.23 No.1 (2023) , 387
Suggested Citation
Trirattanapikul A., Pasomsub E., Siriyotha S., Pattanaprateep O., Phuphuakrat A. Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing. BMC infectious diseases Vol.23 No.1 (2023) , 387. doi:10.1186/s12879-023-08355-0 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/87612
Title
Diagnostic stewardship to limit repeat plasma cytomegalovirus viral load testing
Author's Affiliation
Other Contributor(s)
Abstract
BACKGROUND: Frequent serial monitoring of plasma cytomegalovirus (CMV) viral load caused unnecessary budgets for laboratory testing without changes in treatment. We aimed to implement diagnostic stewardship to limit CMV viral load testing at appropriate intervals. METHODS: A quasi-experimental study was performed. To avoid unnecessary plasma CMV viral load testing, the inpatient electronic pop-up reminder was launched in 2021. In cases with plasma CMV viral load testing was ordered in intervals of less than five days, telephone interview and feedback were performed. Pre-post intervention data was compared in terms of clinical and monetary outcomes. The rate of plasma CMV viral load testing performed in intervals of less than five days was compared between 2021 and 2019 using the Poisson regression model. RESULTS: After the protocol implementation, there was a significant decrease in the rate of plasma CMV viral load test orders in intervals of less than five days from 17.5% to 8.0% [incidence rate ratio 0.40, p < 0.001]. There was no statistically significant difference in the incidence of CMV DNAemia and CMV disease (p = 0.407 and 0.602, respectively). As a result, the hospital could save the costs of plasma CMV viral load testing per 1,000 patients performed with intervals of less than five days from 2,646,048.11 to 1,360,062.89 Thai Baht. CONCLUSIONS: The diagnostic stewardship program is safe and helpful in reducing unnecessary plasma CMV viral load testing and costs.