Outpatient erythropoietin administered through a protocol-driven, pharmacist-managed program may produce significant patient and economic benefits.
To assess the effect of a disease management program in anemia of chronic kidney disease (CKD), the authors reviewedthe records of all adults treated with epoetin alfa (EPO) at their institution between September 2003 and April 2006 and compared them with a group treated through a pharmacist-managed program with patients managed by PCPs in terms of time to target hemoglobin (Hb) (11-12.9 mg/dL), percent of Hb values maintained in target range, average weekly dose of EPO, and percent of iron-saturation (T-sat) values within target range (20%-50%) over a period of six months to one year. Although pharmacist-managed patients received lower weekly EPO doses than those managed by PCPs (6,698 vs. 12,000 units, respectively; P = .0001), they achieved goal Hb faster (47.5 vs. 62.5 days, P = .11) and maintained a higher percentage of Hb and T-sat values in target range (69.8% vs. 43.9%, P = .0001, and 64.8% (vs. 40.4%, respectively; P = .043). A pharmacist-managed program may present significant clinicaland economic benefits in anemia of CKD.
Bucaloiu
Ion D
ID
Department of Nephrology, Geisinger Medical Center, Danville, Pennsylvania 17822, USA. idbucaloiu@geisinger.edu
Akers
Gwendolyn
G
Bermudez
Maria C
MC
Mainali
Roshan
R
Brown
Barbara L
BL
Roberts
Stephanie S
SS
Hartle
James E
JE
D000553:Ambulatory Care / Q000191:economics*; D002985:Clinical Protocols; D004921:Erythropoietin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006279:Health Maintenance Organizations; D006801:Humans; D008485:Medical Audit; D017063:Outcome Assessment, Health Care / Q000191:economics; D010414:Pennsylvania; D010595:Pharmacists; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000188:drug therapy; D012189:Retrospective Studies
D004921:Erythropoietin