Pharmacist collaborative practice agreement for the management of anemia in malignant disease with erythropoiesis-stimulating agents

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• 作者：Elizabeth Weil ; Carolyn Oxencis
• 关键词：Anemia ; Erythropoiesis ; stimulating agents ; ESA ; Procrit ; Collaborative practice agreement
• 刊名：Supportive Care in Cancer
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：23
• 期：8
• 页码：2507-2513
• 全文大小：337 KB
• 参考文献：1.Green MR (2014) Symptom management. In: American Society of Health-System Pharmacists, Inc and American College of Clinical Pharmcy Preparatory Review and Recertification Course
  2.(2008) Procrit (epoetin alfa) package insert. Thousand Oaks: Amgen Inc
  3.(2001) Aranesp (darbepoetin alfa) package insert. Thousand Oaks: Amgen Inc
  4.Amgen Inc. (2013) Epogen/Procrit Risk Evaluation and Mitigation Strategy (REMS). www.?fda.?gov . Accessed 13 Mar 2013
  5.Smith RE, Aapro MS, Ludwig H et al (2008) Darbepoetin alfa for the treatment of anemia in patients with active cancer not receiving chemotherapy or radiotherapy: results of a phase III, multicenter, randomized, doubleblind, placebo-controlled study. J Clin Oncol 26:1040-050PubMed View Article
  6.National Comprehensive Cancer Network NCCN guidelines cancer and chemotherapy-induced anemia. (V1.2014)
  7.National Comprehensive Cancer Network NCCN guidelines myelodysplastic syndromes. (V2fs.2014)
  8.Rizzo JD, Brouwers M, Hurley P, Seidenfeld J, Arcasoy MO et al (2010) ASCO-ASH clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer. J Clin Oncol 28(33):4996-010PubMed View Article
  
• 作者单位：Elizabeth Weil (1)
  Carolyn Oxencis (1)
  
  1. Froedtert & the Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Nursing
  Nursing Management and Research
  Pain Medicine
  Rehabilitation Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-7339

文摘

Purpose Erythropoiesis-stimulating agents (ESAs) reduce transfusions and increase hemoglobin levels in patients with anemia of malignant disease. A medication guideline and pharmacist collaborative practice agreement (CPA) were developed and implemented to standardize ESA prescribing workflow. The use of ESAs in malignant diseases, in accordance with institutional guidelines, was evaluated to ensure safe and effacious use. Methods An observational study was conducted on all ESA doses given throughout a health system’s cancer clinics prior to and after implementation of an ESA guideline and pharmacist CPA. The primary outcome measured was ESA therapy initiated in accordance with guidelines before and after the intervention. Secondary outcomes evaluated were nurse and pharmacist satisfaction, vitals recorded prior to dose, and transfusion rates in patients receiving ESA therapy before and after the intervention. Results In the pre-implementation group, criteria for initiation were not met by any of the 39 patients; prior to therapy, 5.1?% of patients had not had hemoglobin drawn, 23?% of patients had no iron studies completed, and 29.4?% of myelodysplastic syndrome (MDS) patients had no erythropoietin levels drawn. In the post-implementation group, prior to therapy, all patients had hemoglobin levels drawn, 16.67?% did not have iron studies completed, and all MDS patients had erythropoietin levels drawn appropriately. Chemotherapy-induced anemia (CIA) patients in the pre-implementation group had 71.4?% compliance with receiving chemotherapy within 8?weeks of ESA dose, and the post-implementation group had 100?% compliance. Conclusion An ESA guideline and pharmacist CPA aligned prescribing practices with the NCCN and ASCO guidelines and improved staff satisfaction.