Implications for Social Workers:    Click on the link at left to go to your desired page:  Introduction  Page 2  Page 3  Study 1  Study 2  Study 3  Study 4  Conclusion  Post-Test

The effectiveness of palivizumab (Synagis) therapy has been documented in several controlled clinical trials and in practice by reducing the recurring hospitalizations that can be devastating to premature infants, as well as children with lung disease and congenital heart disease who have contracted respiratory syncytial virus (RSV). Palivizumab is preferred because of safety and ease of administration. The major concerns for the medical community are related to two factors: administration site complications and the cost of treatment. Both of these factors can have an impact on the potential compliance of families with young children needing this therapy that want to improve their child's quality of life.

The role of the clinical social worker, as a member of the multidisciplinary team, would be to assist in optimizing compliance in the following four ways:

Ø      Assess for financial cost issues and ways to resolve them utilizing third party reimbursement or other financial resource eligibility.

Ø      Assist the family team by educating the them as to the potential benefits to the patient and family's quality of life, as well as the decreased hospitalization utilization and costs that can be had by completing the entire treatment regimen.

Ø      If regimen is office administered, assist with family transportation needs in order to increase compliance to full treatment course.

Ø      Assess for additional psychosocial barriers in family system functioning that might be non-compliance triggers, using specific counseling intervention strategies. Examples of these include parents who have role functioning problems due to depression, substance abuse, marital discord, anxiety, or unemployment. The social work counseling support for parents with diminished parental coping skills would be aimed at increasing the child’s potential quality of life improvements by completing the treatment regimen.

 Key to the effectiveness of palivizumab therapy is compliance. Completing the full regimen is the only way this drug can be relied on to achieve the results documented in this Journal Club. By policing the compliance issue, the social worker and other team members need to carefully examine the range of factors that can affect the barriers to successful compliance.