CPC-109 Pharmacy Intravenous Iron Protocol in a Central Hospital

Abstract

Background Iron deficiency anaemia (IDA) is a common condition. The pharmacy intravenous iron protocol (100 mg/5 ml iron sucrose vials) includes assessment of patient analytical data, dose calculation, schedule and information about iron administration intended to prevent adverse reactions. Purpose To assess the use of intravenous iron in hospitalised patients being treated by the pharmacy protocol. Materials and Methods An eight-month retrospective, observational study (January to August 2012). Hospitalized patients treated with pharmacist-managed intravenous iron were selected. Demography, main diagnosis, comorbidities, basic data, dosage suggestions and haemoglobin and haematocrit values were collected from electronic clinical files and pharmacotherapeutic profiles. ResultsA total of 35 patients (19 male) were included. Mean age was 75.9 years (range 43–94). 9 (25.7%) patients were admitted for surgery and 26 (74.3%) for a variety of medical conditions. 20 patients (57.1%) were treated without complete investigation of the anaemia. The most frequent intravenous iron dosage was 200 mg 3x week. 27 (77.1%) patients had increased haemoglobin and haematocrit values after an average of 10.3 days (range 3–20) of intravenous iron replacement treatment. The mean increase in haemoglobin concentration was 2.5 g/dl (range 0.2–6.6). Only 9 patients (25.7%) achieved the haemoglobin target during admission. The majority of patients were discharge before achieving the target haemoglobin. No adverse reactions were reported to the pharmacist. Conclusions As stated in the literature, a large proportion of patients in our study were not confirmed to be iron deficient. Pharmacist should advise physicians about the importance of a complete IDA study before starting this therapy. The information about iron administration and a test dose in the pharmacy protocol seem to be useful in preventing adverse reactions. No conflict of interest.