Optimization use of stimulating factors of erythropoiesis

• Autores: M. A. González Fernández, T. Roldán Sevilla, Alicia Herrero Ambrosio
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 15, Nº. 5, 2013, págs. 321-328
• Idioma: inglés
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• Resumen

  • Objective: To describe and evaluate the effectiveness of a program to adjust the prescription and dispensing of Erythropoiesis-Stimulating Factors (ESF) based on the hemoglobin (Hb) levels of the patients attending the Pharmacy Department, adjusting them to the pre-defined safety objectives. The secondary objective is to analyze the prescribing trends of ESF and doses throughout the study. Method: Retrospective, observational study in a 1,300 bed tertiary hospital. The data of patients monitoring was obtained from the programs Farmatools and Labrack. We agreed on an «Optimization program of (using) ESF» with the Nephrology Department and results were analyzed pre-and post-implementation. Results: ESF were dispensed to 329, 259 and 215 patients in January 2010, January 2011 and October 2011 respectively, divided into three groups of patients: patients in pre-dialysis, Continuous Ambulatory Peritoneal Dialysis (CAPD), and dialysis centers. The percentage of patients with Hb >12.5 g/dL is significantly reduced in each group. The percentage of patients belonging to subgroup of Hb (10-12.5) g/dL also increases. The use of darbepoetin increases in the three groups of patients: 20% (p <0.01) in pre-dialysis, 14.9% (p >0.05) in CAPD and 11.42% (p <0.05) in dialysis centers. The prescription of epoetin alfa and beta decreases. The average doses prescribed of darbepoetin and pegylated epoetin also decreased in all groups of patients. Conclusion: ESF optimization program has successfully adjusted the Hb levels of patients with ESF based on the set targets, thereby improving their safety profile