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Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study
BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are recommended for treating anemia in patients with chronic kidney disease and end-stage renal disease. However, misappropriate and over-use of these agents can be costly and unnecessary in some settings. OBJECTIVE: The primary aim was to identif...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705120/ https://www.ncbi.nlm.nih.gov/pubmed/29182650 http://dx.doi.org/10.1371/journal.pone.0188390 |
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author | Alabdan, Numan AlRuthia, Yazed Yates, Mary E. D. Sales, Ibrahim Finch, Christopher K. Hudson, Joanna Q. |
author_facet | Alabdan, Numan AlRuthia, Yazed Yates, Mary E. D. Sales, Ibrahim Finch, Christopher K. Hudson, Joanna Q. |
author_sort | Alabdan, Numan |
collection | PubMed |
description | BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are recommended for treating anemia in patients with chronic kidney disease and end-stage renal disease. However, misappropriate and over-use of these agents can be costly and unnecessary in some settings. OBJECTIVE: The primary aim was to identify predictors of adherence to a newly approved ESA inpatient ordering policy. The secondary aims were to evaluate the impact of a 5-day delay in the initiation of ESA therapy on ESA usage, hemoglobin (Hb) levels, and costs. METHODS: This retrospective observational record review included a sample of adult patients admitted to four tertiary care hospitals from November 1, 2013 to August 31, 2014. Multivariable logistic and linear regression analyses were used to calculate the odds of adherence to the new ESA inpatient ordering policy and the impact of this policy on discharge Hb level, respectively. RESULTS: A total of 242 patients were included. The majority of the prescribers (77%) adhered to the new ESA ordering policy. Hemoglobin (OR = 1.306; 95% CI: 1.03–1.65) and ferritin (OR = 3.91; 95% CI: 1.23–12.51) levels at admission and length of hospital stay were positively correlated with the odds of patients receiving ESAs after day 5 (OR = 1.12; 95% CI:1.05–1.20). Furthermore, adherence to the new policy did not have a significant impact on discharge Hb level (β = 0.02349; P = 0.895). CONCLUSIONS: Prescribers were adherent to a 5-day delay in the initiation of ESA therapy policy which resulted in a reduction in ESA usage, did not impact the discharge Hb levels, and was proven to be cost effective. |
format | Online Article Text |
id | pubmed-5705120 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-57051202017-12-08 Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study Alabdan, Numan AlRuthia, Yazed Yates, Mary E. D. Sales, Ibrahim Finch, Christopher K. Hudson, Joanna Q. PLoS One Research Article BACKGROUND: Erythropoiesis-stimulating agents (ESAs) are recommended for treating anemia in patients with chronic kidney disease and end-stage renal disease. However, misappropriate and over-use of these agents can be costly and unnecessary in some settings. OBJECTIVE: The primary aim was to identify predictors of adherence to a newly approved ESA inpatient ordering policy. The secondary aims were to evaluate the impact of a 5-day delay in the initiation of ESA therapy on ESA usage, hemoglobin (Hb) levels, and costs. METHODS: This retrospective observational record review included a sample of adult patients admitted to four tertiary care hospitals from November 1, 2013 to August 31, 2014. Multivariable logistic and linear regression analyses were used to calculate the odds of adherence to the new ESA inpatient ordering policy and the impact of this policy on discharge Hb level, respectively. RESULTS: A total of 242 patients were included. The majority of the prescribers (77%) adhered to the new ESA ordering policy. Hemoglobin (OR = 1.306; 95% CI: 1.03–1.65) and ferritin (OR = 3.91; 95% CI: 1.23–12.51) levels at admission and length of hospital stay were positively correlated with the odds of patients receiving ESAs after day 5 (OR = 1.12; 95% CI:1.05–1.20). Furthermore, adherence to the new policy did not have a significant impact on discharge Hb level (β = 0.02349; P = 0.895). CONCLUSIONS: Prescribers were adherent to a 5-day delay in the initiation of ESA therapy policy which resulted in a reduction in ESA usage, did not impact the discharge Hb levels, and was proven to be cost effective. Public Library of Science 2017-11-28 /pmc/articles/PMC5705120/ /pubmed/29182650 http://dx.doi.org/10.1371/journal.pone.0188390 Text en © 2017 Alabdan et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Alabdan, Numan AlRuthia, Yazed Yates, Mary E. D. Sales, Ibrahim Finch, Christopher K. Hudson, Joanna Q. Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
title | Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
title_full | Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
title_fullStr | Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
title_full_unstemmed | Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
title_short | Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
title_sort | predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: a cross-sectional study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705120/ https://www.ncbi.nlm.nih.gov/pubmed/29182650 http://dx.doi.org/10.1371/journal.pone.0188390 |
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