■在COVID-19大流行期间,用于暴露前预防的SARS-CoV-2单克隆抗体(SMA-PrEP)为免疫功能低下的患者提供了另一种保护选择。然而,SMA-PrEP提出了行政管理,操作,以及医疗机构面临的道德挑战,导致很少有患者接受它们。虽然第一个SMA-PrEP药物,tixagevimab和西加维玛,由于体外功效受损而撤销了授权,新的SMA-PrEP药物目前正在完成临床试验.本文为行政组织提供了一个操作框架,患者识别和优先排序,公平的药物分配,药物订购和管理,患者追踪
■进行了一项回顾性队列研究,评估了我们医院的SMA-PrEP给药策略。多变量logistic回归用于检查与接受SMA-PrEP相关的因素。
■尽管使用这种药物存在障碍和资源稀缺,我们医院能够对5902例符合条件的患者中的1,59例(23.0%)给予至少1剂SMA-PrEP.即使采取了促进公平分配的步骤,多变量逻辑回归表明,种族之间仍然存在差异,种族,和社会经济地位。与被认定为布莱克的患者相比,确定为白人的患者(比值比[OR],1.85;95%CI,1.46-2.33),亚洲(或,1.59;95%CI,1.03-2.46),和西班牙裔(或者,1.53;95%CI,1.02-2.44)更有可能接受SMA-PrEP。与社会经济地位较低的患者相比,社会经济地位高的患者(OR,1.37;95%CI,1.05-1.78)更有可能被分配SMA-PrEP。
■尽管努力减轻医疗保健差距,在接受SMA-PrEP的患者中,仍然存在种族/民族和社会经济地位的差异.
UNASSIGNED: During the COVID-19 pandemic, SARS-CoV-2 monoclonal antibodies for preexposure prophylaxis (SMA-PrEP) offered patients who were immunocompromised another option for protection. However, SMA-PrEP posed administrative, operational, and ethical challenges for health care facilities, resulting in few patients receiving them. Although the first SMA-PrEP medication, tixagevimab and cilgavimab, had its authorization revoked due to compromised in vitro efficacy, new SMA-PrEP medications are currently completing clinical trials. This article provides an operational framework for administrative organization, patient identification and prioritization, equitable medication
allocation, medication ordering and administration, and patient tracking.
UNASSIGNED: A retrospective cohort study evaluating our hospital\'s SMA-PrEP administration strategy was performed. Multivariable logistic regression was used to examine factors associated with receipt of SMA-PrEP.
UNASSIGNED: Despite the barriers in administering this medication and the scarcity of resources, our hospital was able to administer at least 1 dose of SMA-PrEP to 1359 of 5902 (23.0%) eligible patients. Even with the steps taken to promote equitable
allocation, multivariable logistic regression demonstrated that there were still differences by race, ethnicity, and socioeconomic status. As compared with patients who identified as Black, patients who identified as White (odds ratio [OR], 1.85; 95% CI, 1.46-2.33), Asian (OR, 1.59; 95% CI, 1.03-2.46), and Hispanic (OR, 1.53; 95% CI, 1.02-2.44) were more likely to receive SMA-PrEP. When compared with patients with low socioeconomic status, patients with high socioeconomic status (OR, 1.37; 95% CI, 1.05-1.78) were more likely to be allocated SMA-PrEP.
UNASSIGNED: Despite efforts to mitigate health care disparities, differences by race/ethnicity and socioeconomic status still arose in patients receiving SMA-PrEP.