Follow-up of a clinical pathway for varicella-zoster virus infection

García-Castrillo Riesgo L, Mariné Blanco M, Martínez Ortiz de Zárate M, Piñera Salmerón P

Background: Evaluation, follow-up and healthcare professional acceptance are critical

issues in the implementation of a clinical pathway (CP).

Aims: To evaluate the performance of a varicella-zoster virus (VZV) pathway in different

Emergency Departments (ED).

Design: Observational prospective multicenter study in 49 EDs (local, reference and intermediate

EDs). The subjects of the study were patients older than 14 years with a clinical

diagnosis of varicella or herpes who were assisted at all EDs during the whole

study period (Feb-Jul 2007). Data on demographic, clinical characteristics and application

of CP were recorded. Acceptance of CP was assessed by survey.

Results: The study included 929 herpes and 427 varicella patients. Our VZV cases had

a higher admission and complication rates than the cases reported on previous publications,

which reflects higher severity. CP recommendations were applied in 75% of varicella

and 85,3% of herpes cases. Reference and local EDs had higher rates of CP application

(95%, 87.7%) than intermediate EDs (72.9%) (P < 0.01). Ninety five percent of responders evaluated information and treatment on CP as “useful or very useful”. The most appreciated feature of CP was information. Conclusions: The level of acceptance of VZV CP is high. The severity of certain cases requires to adjust the recommendations.

García-Castrillo Riesgo L, Mariné Blanco M, Martínez Ortiz de Zárate M, Piñera Salmerón P