One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project
Background: Current aspirin desensitization protocols for aspirin-exacerbated respiratory disease (AERD) require from 1 to 3 days to complete. Objective: Our aim was to assess the implementation of a 1-day versus 2-day aspirin desensitization protocol in patients with aspirin-exacerbated respiratory...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-11-01
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| Series: | Journal of Allergy and Clinical Immunology: Global |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772829323000838 |
| _version_ | 1797632605715169280 |
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| author | Emily Gansert, BS Dan Morgenstern-Kaplan, MD, MS Angela M. Donaldson, MD Matthew A. Rank, MD Alexei Gonzalez-Estrada, MD |
| author_facet | Emily Gansert, BS Dan Morgenstern-Kaplan, MD, MS Angela M. Donaldson, MD Matthew A. Rank, MD Alexei Gonzalez-Estrada, MD |
| author_sort | Emily Gansert, BS |
| collection | DOAJ |
| description | Background: Current aspirin desensitization protocols for aspirin-exacerbated respiratory disease (AERD) require from 1 to 3 days to complete. Objective: Our aim was to assess the implementation of a 1-day versus 2-day aspirin desensitization protocol in patients with aspirin-exacerbated respiratory disease. Methods: We used a preintervention-postintervention quality improvement design to compare the completion rates, reaction rates, and estimated costs of a 2-day versus 1-day aspirin desensitization. The cost for each desensitization was estimated on the basis of 2017-2020 US Medicare standards. We included the predesensitization variables for FEV1 value, urinary leukotriene E4 level, absolute eosinophil count (AEC), and total IgE level for each group. Results: A total of 15 patients underwent a 2-day aspirin desensitization in the 4-year (2017-2020) preintervention period and were compared with 8 patients who underwent a 1-day aspirin desensitization in the 1-year (2021) postintervention period. The desensitization completion rate (93% vs 100% [P = 1]) and the mean number of reactions requiring intervention during the desensitization protocols (0.26 vs 0.8 [P = .14]) were similar between groups. The average time frame between last polypectomy and desensitization was longer in the 2-day group (1946 vs 39.2 days [P = .03]). The mean values for FEV1 level, urinary leukotriene E4 level, absolute eosinophil count, and total IgE level were 76% vs 83% (P = .6), 1084 vs 385 pg/mg (P = .2), 686 vs 306 cells/μL (P = .74), and 735 vs 278 kU/L (P = .5), respectively. The estimated direct cost reduction was $762 per aspirin desensitization for using 1-day vs 2-day aspirin desensitization. Conclusion: Compared with a 2-day protocol, the implementation of a 1-day aspirin desensitization was characterized by similar completion and reaction rates as well as lower costs. |
| first_indexed | 2024-03-11T11:40:11Z |
| format | Article |
| id | doaj.art-108c74981e4a425fa8a10bf655b06daa |
| institution | Directory Open Access Journal |
| issn | 2772-8293 |
| language | English |
| last_indexed | 2024-03-11T11:40:11Z |
| publishDate | 2023-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Allergy and Clinical Immunology: Global |
| spelling | doaj.art-108c74981e4a425fa8a10bf655b06daa2023-11-10T04:16:54ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932023-11-0124100158One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement projectEmily Gansert, BS0Dan Morgenstern-Kaplan, MD, MS1Angela M. Donaldson, MD2Matthew A. Rank, MD3Alexei Gonzalez-Estrada, MD4Division of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FlaDivision of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FlaDepartment of Otorhinolaryngology (ENT)/Head and Neck Surgery, Mayo Clinic, Jacksonville, FlaDivision of Allergy, Asthma, and Clinical Immunology, Department of Medicine, Mayo Clinic, Scottsdale, ArizDivision of Pulmonary, Allergy, and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, Fla; Corresponding author: Alexei Gonzalez-Estrada, MD, Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, 4500 San Pablo Rd, Jacksonville, FL 32224.Background: Current aspirin desensitization protocols for aspirin-exacerbated respiratory disease (AERD) require from 1 to 3 days to complete. Objective: Our aim was to assess the implementation of a 1-day versus 2-day aspirin desensitization protocol in patients with aspirin-exacerbated respiratory disease. Methods: We used a preintervention-postintervention quality improvement design to compare the completion rates, reaction rates, and estimated costs of a 2-day versus 1-day aspirin desensitization. The cost for each desensitization was estimated on the basis of 2017-2020 US Medicare standards. We included the predesensitization variables for FEV1 value, urinary leukotriene E4 level, absolute eosinophil count (AEC), and total IgE level for each group. Results: A total of 15 patients underwent a 2-day aspirin desensitization in the 4-year (2017-2020) preintervention period and were compared with 8 patients who underwent a 1-day aspirin desensitization in the 1-year (2021) postintervention period. The desensitization completion rate (93% vs 100% [P = 1]) and the mean number of reactions requiring intervention during the desensitization protocols (0.26 vs 0.8 [P = .14]) were similar between groups. The average time frame between last polypectomy and desensitization was longer in the 2-day group (1946 vs 39.2 days [P = .03]). The mean values for FEV1 level, urinary leukotriene E4 level, absolute eosinophil count, and total IgE level were 76% vs 83% (P = .6), 1084 vs 385 pg/mg (P = .2), 686 vs 306 cells/μL (P = .74), and 735 vs 278 kU/L (P = .5), respectively. The estimated direct cost reduction was $762 per aspirin desensitization for using 1-day vs 2-day aspirin desensitization. Conclusion: Compared with a 2-day protocol, the implementation of a 1-day aspirin desensitization was characterized by similar completion and reaction rates as well as lower costs.http://www.sciencedirect.com/science/article/pii/S2772829323000838Aspirin-exacerbated respiratory diseaseaspirin desensitizationquality improvementnonsteroidal anti-inflammatory drugs |
| spellingShingle | Emily Gansert, BS Dan Morgenstern-Kaplan, MD, MS Angela M. Donaldson, MD Matthew A. Rank, MD Alexei Gonzalez-Estrada, MD One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project Journal of Allergy and Clinical Immunology: Global Aspirin-exacerbated respiratory disease aspirin desensitization quality improvement nonsteroidal anti-inflammatory drugs |
| title | One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project |
| title_full | One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project |
| title_fullStr | One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project |
| title_full_unstemmed | One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project |
| title_short | One- versus 2-day aspirin desensitization in aspirin exacerbated respiratory disease: A quality improvement project |
| title_sort | one versus 2 day aspirin desensitization in aspirin exacerbated respiratory disease a quality improvement project |
| topic | Aspirin-exacerbated respiratory disease aspirin desensitization quality improvement nonsteroidal anti-inflammatory drugs |
| url | http://www.sciencedirect.com/science/article/pii/S2772829323000838 |
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