Appropriate Use of Inpatient Erythropoiesis Stimulating Agents
Background: Anemia is a significant global public health issue, and it is associated with lethargy, weakness, tiredness, and shortness of breath. Erythropoietin stimulating agents (ESAs) are recombinant / synthetic erythropoietin and can increase hemoglobin (Hb) levels. There are increased risks of...
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University of Minnesota Libraries Publishing
2024-11-01
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| Series: | INNOVATIONS in Pharmacy |
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| Online Access: | https://pubs.lib.umn.edu/index.php/innovations/article/view/6284 |
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| author | Chenghao Cui Timothy Nguyen Mohammad Rattu |
| author_facet | Chenghao Cui Timothy Nguyen Mohammad Rattu |
| author_sort | Chenghao Cui |
| collection | DOAJ |
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Background: Anemia is a significant global public health issue, and it is associated with lethargy, weakness, tiredness, and shortness of breath. Erythropoietin stimulating agents (ESAs) are recombinant / synthetic erythropoietin and can increase hemoglobin (Hb) levels. There are increased risks of cardiovascular events and death associated with the use of ESAs when raising Hb levels above 12 g/dL.
Methods: This was a baseline safety assessment via a retrospective chart review, including patients who recently received an inpatient dose of an ESA within The Mount Sinai Hospital (MSH) from November 1, 2015 (after MSH ESA guideline revision) to August 1, 2023. All adult patients who received an ESA (originator or biosimilar products) during hospitalization were included. Data collection was in reverse chronology, and only the most recent dose administered to each unique patient was collected.
Results: If an ESA dose was dispensed when the Hb was less than the upper limit of the target Hb for the specific indication, this was considered appropriate use. Based on data from June 15 to August 1, 2023 (~47 days of inpatient utilization), for the primary outcome, 169 out of 171 doses (98.8%) met the predefined criteria for appropriateness. One dose was dispensed when the Hb was 11.1 g/dL to a patient on renal replacement therapy, and one dose was dispensed when the Hb was 13.8 g/dL to a surgical patient who refused blood transfusions. Among secondary outcomes of interest, there was a difference in blood transfusions administered in critical versus non-critical care settings.
Conclusion: Inpatient use of ESA at MSH was appropriate when looking at Hb targets. There are currently no formal order sets, service-line restrictions, or additional chairperson approvals needed at MSH. Despite this, there remained significant adherence to prevailing Hb targets, reflecting provider and pharmacy teams' knowledge and awareness of contemporary best practices.
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| format | Article |
| id | doaj-art-a146389ab9724305b1ecf059746ac601 |
| institution | Kabale University |
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| language | English |
| publishDate | 2024-11-01 |
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| series | INNOVATIONS in Pharmacy |
| spelling | doaj-art-a146389ab9724305b1ecf059746ac6012025-02-09T21:38:43ZengUniversity of Minnesota Libraries PublishingINNOVATIONS in Pharmacy2155-04172024-11-0115410.24926/iip.v15i4.6284Appropriate Use of Inpatient Erythropoiesis Stimulating AgentsChenghao Cui0Timothy Nguyen1Mohammad Rattu2The Mount Sinai Hospital, New York, NYLIU (Long Island University)The Mount Sinai Hospital, New York, NY Background: Anemia is a significant global public health issue, and it is associated with lethargy, weakness, tiredness, and shortness of breath. Erythropoietin stimulating agents (ESAs) are recombinant / synthetic erythropoietin and can increase hemoglobin (Hb) levels. There are increased risks of cardiovascular events and death associated with the use of ESAs when raising Hb levels above 12 g/dL. Methods: This was a baseline safety assessment via a retrospective chart review, including patients who recently received an inpatient dose of an ESA within The Mount Sinai Hospital (MSH) from November 1, 2015 (after MSH ESA guideline revision) to August 1, 2023. All adult patients who received an ESA (originator or biosimilar products) during hospitalization were included. Data collection was in reverse chronology, and only the most recent dose administered to each unique patient was collected. Results: If an ESA dose was dispensed when the Hb was less than the upper limit of the target Hb for the specific indication, this was considered appropriate use. Based on data from June 15 to August 1, 2023 (~47 days of inpatient utilization), for the primary outcome, 169 out of 171 doses (98.8%) met the predefined criteria for appropriateness. One dose was dispensed when the Hb was 11.1 g/dL to a patient on renal replacement therapy, and one dose was dispensed when the Hb was 13.8 g/dL to a surgical patient who refused blood transfusions. Among secondary outcomes of interest, there was a difference in blood transfusions administered in critical versus non-critical care settings. Conclusion: Inpatient use of ESA at MSH was appropriate when looking at Hb targets. There are currently no formal order sets, service-line restrictions, or additional chairperson approvals needed at MSH. Despite this, there remained significant adherence to prevailing Hb targets, reflecting provider and pharmacy teams' knowledge and awareness of contemporary best practices. https://pubs.lib.umn.edu/index.php/innovations/article/view/6284anemiaerythropoiesis stimulating agentserythropoietin |
| spellingShingle | Chenghao Cui Timothy Nguyen Mohammad Rattu Appropriate Use of Inpatient Erythropoiesis Stimulating Agents INNOVATIONS in Pharmacy anemia erythropoiesis stimulating agents erythropoietin |
| title | Appropriate Use of Inpatient Erythropoiesis Stimulating Agents |
| title_full | Appropriate Use of Inpatient Erythropoiesis Stimulating Agents |
| title_fullStr | Appropriate Use of Inpatient Erythropoiesis Stimulating Agents |
| title_full_unstemmed | Appropriate Use of Inpatient Erythropoiesis Stimulating Agents |
| title_short | Appropriate Use of Inpatient Erythropoiesis Stimulating Agents |
| title_sort | appropriate use of inpatient erythropoiesis stimulating agents |
| topic | anemia erythropoiesis stimulating agents erythropoietin |
| url | https://pubs.lib.umn.edu/index.php/innovations/article/view/6284 |
| work_keys_str_mv | AT chenghaocui appropriateuseofinpatienterythropoiesisstimulatingagents AT timothynguyen appropriateuseofinpatienterythropoiesisstimulatingagents AT mohammadrattu appropriateuseofinpatienterythropoiesisstimulatingagents |