Improving the Quality of Care of Respiratory Syncytial Virus in the neonatal and pediatric populations globally

Fungwe Jah^1*Asuncion Mejias²Tendai Nzirawa³Rita C Silveira⁴Angelika Berger⁵Laura Travan⁶Daisuke Kinoshita⁷Shareena Ishak⁸Tolga Çelik⁹Faisal Al-Dandan¹⁰Benedikt Mahr¹¹Christine Masters¹²

• ¹AstraZeneca (Germany), Wedel, Germany
• ²Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee, United States
• ³Pediatric Pan London Oxygen Group, London, United Kingdom
• ⁴Clinical Hospital of Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
• ⁵Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Vienna, Austria
• ⁶Institute for Maternal and Child Health Burlo Garofolo (IRCCS), Trieste, Friuli-Venezia Giulia, Italy
• ⁷Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Kyōto, Japan
• ⁸Hospital Chancellor Tuanku Muhriz, National University of Malaysia, Cheras, Kuala Lumpur, Malaysia
• ⁹Hacettepe University Hospital, Ankara, Ankara, Türkiye
• ¹⁰Maternity and Children Hospital Al-Ahsa, AlHasa, Saudi Arabia
• ¹¹AstraZeneca (Austria), Vienna, Austria
• ¹²AstraZeneca (United Kingdom), London, England, United Kingdom

Respiratory syncytial virus (RSV) is the leading cause of hospitalization for bronchiolitis in infants worldwide, and age (<6 months) and underlying comorbidities (e.g., prematurity, congenital heart disease) are risk factors for severe disease. However, some centers face challenges in identifying and implementing preventative measures, and best practices, for the care of at-risk infants. Therefore, this study aimed to identify best practice examples in RSV care for neonatal and pediatric populations in leading centers globally, and to understand how these practices can be widely implemented. Following a literature review, multidisciplinary teams were interviewed in 10 centers globally (1 center per country; 40 interviews conducted between May and November 2023). Centers were included based on pre-determined criteria (e.g., type of center, services provided, focus on RSV research) to ensure a representative view of RSV care. The identified best practice interventions were critically reviewed by a group of RSV experts (healthcare professionals (HCPs) and a patient group representative) and assessed for their impact on patient care and transferability to other centers. Fiftyseven unique best practice interventions were identified, sixteen of which were prioritized, across five best practice themes:• Caregiver education and engagement: Provision of timely caregiver education on RSV infection and care. • HCP education: Provision of continuous evidence-based HCP education.• HCP-led RSV prophylaxis services: Additional support services to ensure at-risk infants are protected ahead of the RSV season. • Protocols and ways of working: Establishing evidence-based procedures to ensure best practices are followed within clinical practice. • Technology and innovation: Leveraging digital services to optimize care delivery and experience.This study identified interventions that may improve patient outcomes and quality of care for RSV disease in the pediatric and neonatal populations. The next steps will be to disseminate and implement best practice examples across healthcare systems and care settings globally.