Assessing a pharmacist-run anaemia educational programme for patients with chronic renal insufficiency.
OBJECTIVE
Assessment of a pharmacist-run anaemia educational programme for patients with chronic renal insufficiency.


METHODS
Nephrology Department, Grenoble Hospital, France.


METHODS
A 12-week prospective study, using a before-after intervention design. Included in the study were predialysis outpatients with a haemoglobin level < 10 g/dl, de novo EPO prescription; judged qualified by the nephrologist for self-injections; accepting self-injections. The intervention was a single one-hour individual session between the pharmacist and the patient to target (1) medical and therapeutic information; (2) information on the device, a pen used with a cartridge of beta epoietin; (3) training with the pen; and (4) self-injection of the first dose by the patient, in front of the pharmacist. Main outcome measures were knowledge (7-item questionnaire); handling skills (observation) and Quality of Life (1 Likert scale on apprehension towards self-injections and 3 Linear Analog Scales on energy, daily activities, and general well-being); compliance (self-report on self-administered injections) and haemoglobin level.


RESULTS
Ten patients were followed for 3 months after intervention. The evolution of the knowledge was positive but not statistically significant after the programme (80% of good answers before; 93% 3 months later). Concerning the patients' skills, difficulties with the pen were important at inclusion, (1) to reset the pen into zero position (2.8 tries/patient +/- 1.8); (2) to insert a new cartridge (1.9 +/- 1.1); and (3) to take air out of the cartridge (2.3 +/- 1.2). After the session, results were satisfactory, since 3 months later, all patients were still on self-injections. QoL improved significantly over the study period respectively on energy, daily activities, and general well-being. The mean level of compliance remained above 90% at 3 months for 8 out of 10 patients. Patients reached the haemoglobin target value of 11 g/dl during the second month of treatment.


CONCLUSIONS
A tailored educational programme conducted by a pharmacist is beneficial for anaemia patients with chronic renal insufficiency. The programme seems to result in a high level of compliance, leading to an optimal haemoglobin level within two months.
Allenet
B
B
Département de Pharmacie, Pavillon Moidieu, CHU de Grenoble, BP 217, 38043 Grenoblex 9, France. BAllenet@chu-grenoble.fr
Chen
C
C
Romanet
T
T
Vialtel
P
P
Calop
J
J
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000740:Anemia / Q000209:etiology / Q000628:therapy*; D004921:Erythropoietin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006454:Hemoglobins / Q000187:drug effects; D006784:Hospitals, Teaching; D006801:Humans; D007267:Injections / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D024382:Professional Role; D011446:Prospective Studies; D011788:Quality of Life; D011994:Recombinant Proteins; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012646:Self Administration / Q000379:methods
D006454:Hemoglobins; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin