Refereed journal article or data article (A1)
National treatment guidelines decreased the use of racemic adrenaline for bronchiolitis in four Finnish university hospitals
List of Authors: Sauli Palmu, Minna Mecklin, Paula Heikkilä, Katri Backman, Ville Peltola, Marjo Renko, Matti Korppi
Publisher: Blackwell Publishing Ltd
Publication year: 2018
Journal: Acta Paediatrica
Journal name in source: Acta Paediatrica, International Journal of Paediatrics
Volume number: 107
Issue number: 11
Start page: 1966
End page: 1970
Number of pages: 5
ISSN: 0803-5253
eISSN: 1651-2227
DOI: http://dx.doi.org/10.1111/apa.14397
Aim
Inhaled racemic adrenaline was used for bronchiolitis in many hospitals in Finland prior to new national current care guidelines for bronchiolitis in 2014, which limited its recommendations to on‐demand rescue therapy. We studied the drug's use before and after the new guidelines to gauge changes in prescribing habits.
Methods
This 2012–2016 study analysed how many 0.5 mL doses of racemic adrenaline were used for children by emergency rooms, paediatric wards and paediatric intensive care units at four university hospitals and estimated drug and staff costs.
Results
There were substantial differences in the yearly consumption of racemic adrenaline between the hospitals before and after the bronchiolitis guidelines were published, with reductions in drug costs and staff time. The overall use more than halved during the study period, particularly in two hospitals where baseline consumptions were highest, but not in a third where baseline consumption was already low. In the fourth, the baseline consumption was modest and there was a constant decrease during the study years.
Conclusion
The current care guidelines for bronchiolitis had some impact on clinical practice, as the overall use of racemic adrenaline more than halved, but considerable differences remained in the four study hospitals after their publication.