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RESEARCH PRODUCT

Pharmacotherapy quality and patient safety in haemodialysis patients treated with erythropoiesis-stimulating agents

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Abstract Objective To assess an interdisciplinary programme for the improvement of pharmacotherapy quality and patient safety in patients with chronic renal disease who are treated with erythropoiesisstimulating agents. Method Observational, longitudinal study. Retrospective analysis (period A) and prospective analysis (period B) following implementation of the programme for haemoglobin values and monthly erythropoiesisstimulating agent dosage. The proportion of patients with haemoglobin values within the target range (10-5-12.5 g/dL) and those with values above the safety limit (≥12.5 g/dL) were compared every 4 months and the average percentage of time with haemoglobin values within the target range and above the safety limit were compared during periods A and B. Results Fifty-nine patients were included in the study. The proportion of patients with haemoglobin levels within the target range increased from 28.8% to 65.4% (RR = 2.27; 95% CI, 1.56–3.30) and the value in patients with haemoglobin levels above the safe level reduced from 57.6% to 19.2% (RAR = 0.39; 95% CI, 0.19–0.55). The time with haemoglobin levels in the target range increased 15.7% (95% CI, 7.1–24.2) and the time with values above the safe level reduced 26.9% (95% CI, −35.1 to −18.6). The number of patients included to avoid one reaching a haemoglobin value above the safe range was 2.6 (95% CI, 2.5–2.7). Conclusions The implementation of an improvement programme for the quality of pharmacotherapy with erythropoiesis-stimulating agents in patients with haemodialysis significantly increases the proportion of patients with haemoglobin values within the recommended ranges of effectiveness and safety.