Abstract

A varied approach to the initiation, assessment and delivery of Omalizumab across the United Kingdom has been observed. To analyse the disparity in practize a questionnaire was disseminated to centres administering Omalizumab. Completed questionnaires n=43 (32.5% paediatric/67.5% adult). Questions asked were specific to the initiation, assessment and delivery of Omalizumab, the results identified a wide disparity in practize.

Adherence assessment prior to Omalizumab initiation was completed by all centres; however there was a varied approach of each centre in their assessment. 90.6% assessed prescription records, 74.4% questioned patients regarding medication adherence, 32.5% measured prednisolone levels and 4.6% utilised a validated questionnaire (4.6%) Longitudinally 48.8% continue to monitor adherence every 0–6 months, 27.9% every 6–12 months whilst 11.6% do not cheque adherence long term. Centres were diverse in their period of recommended observation post first dose. 4.6% advocate a 0–60 minute observation, 25.5% 1–2hrs, 39.5%, 2–3 hrs and 23.3% >4hrs, subsequent dose administration also varied across centre 37.2% advocated a 0–30min observation, 25.5% a 30–60min period and 11.6% 2–3hrs (11.6%). Paediatric centres advocated a longer observation period post injection. Across centres there is a huge inconsistency in weight observation 46.5% of centres weigh patients each visit, 27.9% 1–3 monthly and 16.2% 3–6 monthly. Dose of Omalizumab is only altered specific to weight fluctuation by 60.4% of which a higher percentage is practised in paediatric compared to adult centres (71.4%/55.1%). Out of dosing range prescribing is undertaken by 57.1% (paediatric) 29% (adult). Use of adrenaline auto injectors were not advocated by 60.4% of the centres, of the remaining 39.5% who advocate adrenaline auto injectors only 47% of this population have specific guidance relating to length of time to keep the injector available.