title: Establishing an anemia clinic for optimal erythropoietic-stimulating agent use in hematology-oncology patients.
abstract: Erythropoietic-stimulating agent (ESA) therapy has significantly impacted the management of chemotherapy-induced anemia (CIA) by decreasing the number of red blood cell transfusions required by patients with cancer. However, managing these patients with ESA therapy has become increasingly difficult since the release of the Centers for Medicare & Medicaid Services' new National Coverage Determination document because of the disparities between this document and recommendations from expert-reviewed national clinical guidelines on the treatment of anemia. This article describes a collaborative practice agreement between pharmacists and physicians as one approach to managing CIA in hematology-oncology patients in an anemia clinic. The goal of the pharmacist-managed anemia clinic is to improve patient satisfaction and clinical outcomes associated with the treatment of CIA. This article describes the rationale for the clinic and discusses its design and implementation in managing ESA, iron, folate, and vitamin B12 therapy for CIA in hematology-oncology patients. The pharmacist's role is justified in this clinic model through increased adherence to evidence-based practice guidelines and decreased costs associated with ESA therapy.
authors.affiliation: Huntsman Cancer Institute, Department of Pharmacy Services, University of Utah Hospitals and Clinics, Salt Lake City, Utah 84112, USA. jeffrey.gilreath@hci.utah.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Gilreath
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Sageser
authors.forename: James A
authors.initials: JA
authors.lastname: Jorgenson
authors.forename: George M
authors.initials: GM
authors.lastname: Rodgers
mesh_terms: D000740:Anemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D000970:Antineoplastic Agents / Q000009:adverse effects; D006270:Health Facility Administrators; D006397:Hematinics / Q000627:therapeutic use*; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010595:Pharmacists
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics