Proposed Vial Mixing Standard May Have Adverse Effects for Otolaryngologists

Both OIG reports indicate the need for standardized immunotherapy and antigen preparation, he said.

The OIG reports found that 20% of patients getting immunotherapy had no need for the treatment; 13% of patients received immunotherapy despite having contraindications, and 15% had inappropriate allergy testing performed. In addition, 22% of patients continued getting immunotherapy beyond clinical norms and without justification and another 22% received improperly prepared allergy shots that were provided too frequently or in an inappropriate setting.

AAOA Task Force in Action

In the meantime, spurred on by Dr. Lin, the AAOA has created a task force to educate otolaryngologists about the issue, lobby against otolaryngologists having to do immunotherapy mixing under the new standards, and to create vial mixing guidelines specifically for otolaryngologists.

The AAOA task force is working with the Joint Council of Allergy, Asthma and Immunology (JCAAI) task force, and members are in discussions with the USP about possible revisions or exemptions to the proposed standards.

Dr. Lin is also planning further studies relating to vial mixing environments and patient safety. While otolaryngologists suspect mixing vials in the office is safe, actual evidence is always a good thing to have. In addition, she encouraged otolaryngologists at the AAOA to get involved in the process. If we don’t create guidelines for ourselves, someone else will, she said.

©2006 The Triological Society