Objectives: The goal of this systematic review was to identify and summarise algorithm-managed and pharmacist-managed dosing of erythropoietin stimulating agents (ESA) in patients with renal anaemia and to determine the effects on available outcome parameters.
Methods: We followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines for systematic reviews. Studies investigating algorithm-managed and pharmacist-managed dosing of ESA in adult patients with renal anaemia were evaluated for inclusion. No restrictions were set on outcome parameters. Observational and interventional studies available as full-text articles with a control group and follow-up ≥6 months were eligible for inclusion. Relevant databases were searched from their inception through August 2024. Two independent reviewers evaluated all studies. The risk of bias was assessed by the ROBINS-I and RoB1 tools. The protocol of this study was registered in PROSPERO (CRD42021243678).
Results: After screening 140 articles, 17 articles and 4313 patients could be included. Available evidence was of low to moderate quality with a high risk of bias. Data were summarised and tabulated. Meta-analysis was not possible due to the substantial heterogeneity in participants, study design, interventions, comparisons, and outcome parameters. However, standardised metrics could be identified and calculated for haemoglobin and ESA dose. The percentage in target range for haemoglobin varied between 3.5% lower (95% CI -18.67% to +11.67%) to 32.0% higher (95% CI 14.07% to 49.93%) in the pharmacist-managed group versus the control group (n=1401). The range in reduction in ESA dose was 5.45% (95% CI -7.97% to +18.87%) to 49.97% (95% CI 20.32% to 79.61%) in the pharmacist-managed group versus the control group (n=2115).
Conclusion: Low-quality data with high risk of bias suggest that pharmacist-managed renal anaemia may improve the percentage of haemoglobin within target range and reduce the ESA dose. However, meta-analysis was impossible due to substantial heterogeneity. Therefore, no definite conclusions could be drawn on the effectiveness of pharmacist-managed dosing of ESA in renal anaemia.
Prospero Registration Number: CRD42021243678.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/ejhpharm-2024-004366 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Algorithm-managed dosing and pharmacist-managed dosing of erythropoietin stimulating agents in renal anaemia: a systematic review.
Eur J Hosp Pharm
February 2025
Department of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, Groningen, The Netherlands.
Objectives: The goal of this systematic review was to identify and summarise algorithm-managed and pharmacist-managed dosing of erythropoietin stimulating agents (ESA) in patients with renal anaemia and to determine the effects on available outcome parameters.
Methods: We followed the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines for systematic reviews. Studies investigating algorithm-managed and pharmacist-managed dosing of ESA in adult patients with renal anaemia were evaluated for inclusion.
Impact of Time in Therapeutic Range on Adverse Events in Atrial Fibrillation Patients in an Ambulatory Care Setting.
Hosp Pharm
December 2024
Maxor National Pharmacy Services Corp, Amarillo, TX, USA.
This study examines the correlation between time-in-therapeutic range (TTR) and anticoagulation-related adverse events (AEs) in patients with atrial fibrillation (Afib) in a pharmacist-managed ambulatory care clinic. A single-center, retrospective cohort study was conducted at a community hospital-based outpatient anticoagulation clinic to investigate the predictive value of suboptimal TTR percentages for hemorrhagic or thromboembolic events in Afib patients. Eligible participants were aged 18 years or older, diagnosed with Afib, and receiving warfarin therapy as current or past enrollees in the anticoagulation management program.
View Article and Find Full Text PDFA Pharmacist-Managed Hydroxyurea Prescribing Protocol Improves Uptake and Optimization among Patients with Sickle Cell Disease.
Adv Hematol
May 2024
Southern Alberta Rare Blood and Bleeding Disorders Comprehensive Care Program, Foothills Medical Center, Calgary, AB, Canada.
Sickle cell disease (SCD) is a common genetic disorder with potentially serious sequelae that can be effectively treated with hydroxyurea. Despite its favorable benefit-risk profile, hydroxyurea uptake in patients with SCD is low. A pilot study was conducted at the Southern Alberta Rare Blood and Bleeding Disorders (SARBBDs) Comprehensive Care Program between January 2020 and September 2023 to assess the implementation of a pharmacist-led protocol for supporting the uptake of hydroxyurea among eligible patients with SCD and optimizing its dosing.
View Article and Find Full Text PDFImplementing AUC Monitoring in a Pharmacist-Managed Vancomycin Dosing Protocol: A Retrospective Cohort Study.
HCA Healthc J Med
April 2023
HCA Houston Healthcare Kingwood, Kingwood, TX.
Article Synopsis
- A study was conducted to evaluate whether using area-under-the-curve (AUC) monitoring of vancomycin dosing reduces the rates of acute kidney injury (AKI) compared to traditional trough-based dosing in adult patients.
- Data from 121 patients in both AUC and trough groups indicated that AUC monitoring did not significantly reduce AKI rates (16.5% vs. 14.9%), but it did lead to a higher percentage of patients being therapeutically managed at the first follow-up (43.2% vs. 33.9%).
- Ultimately, although AUC monitoring did not decrease AKI incidence, it was effective in achieving the target AUC levels and did not affect mortality or hospital stay duration
Impact of a Pharmacist-Managed Outpatient Parenteral Antimicrobial Therapy (OPAT) Service on Cost Savings and Clinical Outcomes at an Academic Medical Center.
Antimicrob Steward Healthc Epidemiol
January 2023
Department of Pharmacy, University of Oklahoma Medical Center, Oklahoma City, Oklahoma.
Background: Outpatient antimicrobial therapy (OPAT) is managed by a variety of teams, but primarily through an infectious disease clinic. At our medical center, OPAT monitoring is performed telephonically by pharmacists through a collaborative practice agreement under the supervision of an infectious disease physician. The effect of telephonic monitoring of OPAT by pharmacists on patient outcomes is unknown.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!