Frias, Mercedes

Garcia, Yarelys

Jalice, Ada

English

Scholarly Commons@Baptist Health South Florida

Baptist Health South FloridaScholarly Commons @ Baptist Health South FloridaAll Publications12-7-2016Assessment of iron sucrose use at a community-based hospitalAda JaliceSouth Miami Hospital, adaj@baptisthealth.netMercedes FriasSouth Miami Hospital, mercedesf@baptisthealth.netYarelys GarciaSouth Miami Hospital, YarelysGa@baptisthealth.netFollow this and additional works at: https://scholarlycommons.baptisthealth.net/se-all-publicationsPart of the Pharmacy and Pharmaceutical Sciences CommonsThis Conference Poster -- Open Access is brought to you for free and open access by Scholarly Commons @ Baptist Health South Florida. It has beenaccepted for inclusion in All Publications by an authorized administrator of Scholarly Commons @ Baptist Health South Florida. For moreinformation, please contact Carrief@baptisthealth.net.CitationJalice, Ada; Frias, Mercedes; and Garcia, Yarelys, "Assessment of iron sucrose use at a community-based hospital" (2016). AllPublications. 1283.https://scholarlycommons.baptisthealth.net/se-all-publications/1283Printing:This poster is 48” wide by 36” high. It’s designed to be printed on a largeCustomizing the Content:The placeholders in this formatted for you. placeholders to add text, or click an icon to add a table, chart, SmartArt graphic, picture or multimedia file.Tfrom text, just click the Bullets button on the Home tab.If you need more placeholders for titles, make a copy of what you need and drag it into place. PowerPoint’s Smart Guides will help you align it with everything else.Want to use your own pictures instead of ours? No problem! Just rightChange Picture. Maintain the proportion of pictures as you resize by dragging a corner.[BACKGROUND• According to the World Health Organization, two billion people (30% of the world’s population) suffer from anemia.1 Iron deficiency is the primary causative factor in half of these cases.• The standard of care for iron deficiency anemia is oral iron supplementation as it is safe, effective, well tolerated, and inexpensive.2• Parenteral iron therapy is more costly and may cause severe side effects, such as hypotension and anaphylaxis.3 It is indicated as first line in patients who are unable to tolerate or absorb oral preparations, in those with unresolved bleeding, in those undergoing dialysis, and in pregnant women.• Within our hospital system, an algorithm has been proposed to limit the first line use of intravenous (IV) iron sucrose (Venofer®) .OBJECTIVES1. Determine if patients treated with Venofer® as first line therapy for iron replacement met Baptist Health South Florida (BHSF)’s proposed IV iron algorithm criteria2. Assess if patients had hemoglobin, transferrin saturation (TSAT), and ferritin levels drawn at baseline3. Examine potential cost savings associated with proposed algorithmMETHODOLOGY• This retrospective study was approved by the BHSF Institutional Review Board.• An electronic report of all inpatients who received Venofer® in June 2016 was generated by our pharmacy systems specialist.• Patients <18 years old and those who first received oral iron supplementation were excluded.• Of the resultant records, fifty charts were chosen at random to determine if they met the following criteria outlined in BHSF’s proposed algorithm:o Baseline hemoglobin <12 g/dL, TSAT <30%, ferritin <1200 ng/mLo Patient types: -Dialysis-Pregnant women-Gastric surgery -Patients with gastrointestinal (GI) disorders-Patients with malabsorption syndromes-Patients with severe/ongoing blood loss-Patients who cannot receive oral intake (NPO)• For patients who did not meet the above criteria, the total cost of Venofer®doses was calculated.RESULTSDemographicsN=50GenderMale 21 (42%)Female 29 (58%)AgeMean (years) 58• The criteria outlined in our hospital system’s proposed algorithm can greatly streamline the use of parenteral iron therapy.• Since these implications translate into safe and cost effective treatment, a system wide initiative will be implemented to promote the use of oral iron supplementation.DISCUSSION• Out of 50 patients reviewed, 16 (32%) did not fall into the proposed patient types who may receive IV iron first line.• All patients had a baseline hemoglobin level (100%), 18 (36%) had baseline TSAT values, and 23 (46%) had baseline ferritin levels.  • All baseline hemoglobin levels were <12 g/dL (100%). However, only 17 patients (34%) had baseline TSAT <30% and only 21 patients (42%) had baseline ferritin <1200 ng/mL.• On average, inappropriate therapy lasted about 2 days.• Based on our facility’s acquisition cost of $29.61 for one 100 mg vial of Venofer®, the cost of inappropriate parenteral therapy totaled $3,168.• Limitations: Brief study period, small sample size, evaluation of only inpatients, and retrospective data collection that depended on what was documented in the electronic medical record.DISCLOSURESAssessment of iron sucrose use at a community-based hospitalAda S. Jalice, BSHS, PharmD; Mercedes Frías, PharmD; Yarelys Garcia, BSN, PharmDBaseline Laboratory ParametersN=50Hemoglobin 50 (100%)TSAT 18 (36%)Ferritin 23 (46%)Analysis of Inadequate Venofer® Therapyn=16 (32%)TotalDoses administered 36Milligrams administered 10,700Potential Cost SavingsTotal cost $3,168REFERENCESCONCLUSIONS1. World Health Organization. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015.2. Short, M. W., Domagalski, J. E. (2013). Iron deficiency anemia: evaluation and management. Am Fam Physician, 115: 98-s1. 3. VENOFER- iron sucrose injection, solution [package insert]. Shirley, NY: American Regent, Inc.; 2014.Severe/ongoing blood loss34%Pregnant16%GI disorder4%Dialysis8%NPO6%None32%Percent of Patient Types Outlined in Algorithm (N=50)Authors of this presentation have the following to disclose concerning possible financial or personal relationships with commercial entities that may have a direct or indirect interest in the subject matter of this presentation:• Ada S. Jalice: Nothing to disclose• Mercedes Frías: Nothing to disclose• Yarelys Garcia: Nothing to disclose100%34%42%0102030405060708090100Baseline hemoglobin <12 g/dL Baseline TSAT <30% Baseline ferritin <1200 ng/mL% patientsPercent of Patients Meeting Baseline Laboratory Criteria Outlined in Algorithm(N=50)RESULTS

Assessment of iron sucrose use at a community-based hospital

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Assessment of iron sucrose use at a community-based hospital

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