Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study
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. The primary aim was to identify predictors of adheren...
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| creator | Alabdan, Numan AlRuthia, Yazed Yates, Mary E D Sales, Ibrahim Finch, Christopher K Hudson, Joanna Q |
| description | 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.
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.
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.
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).
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. |
| doi_str_mv | 10.1371/journal.pone.0188390 |
| format | Article |
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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.
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.
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).
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0188390</identifier><identifier>PMID: 29182650</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adhesion ; Anemia ; Biology and Life Sciences ; Chronic kidney failure ; Clinical medicine ; Complications and side effects ; Cost control ; Cross-sectional studies ; Delay ; Discharge ; Drug therapy ; End-stage renal disease ; Erythropoiesis ; Ferritin ; Health aspects ; Health care policy ; Hematinics ; Hemodialysis ; Hemoglobin ; Hospitalization ; Hospitals ; Kidney diseases ; Kidney transplantation ; Medicine and Health Sciences ; Patient compliance ; Patient safety ; Patients ; Pharmacists ; Regression analysis ; Risk factors ; Therapy</subject><ispartof>PloS one, 2017-11, Vol.12 (11), p.e0188390-e0188390</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Alabdan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Alabdan et al 2017 Alabdan et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c641t-6551a22bfdba957bb9c8a6fa6da758664d901bf37e6e8be99c2cb42825c9b9eb3</cites><orcidid>0000-0002-0029-5924</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705120/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5705120/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29182650$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Alabdan, Numan</creatorcontrib><creatorcontrib>AlRuthia, Yazed</creatorcontrib><creatorcontrib>Yates, Mary E D</creatorcontrib><creatorcontrib>Sales, Ibrahim</creatorcontrib><creatorcontrib>Finch, Christopher K</creatorcontrib><creatorcontrib>Hudson, Joanna Q</creatorcontrib><title>Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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).
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.</description><subject>Adhesion</subject><subject>Anemia</subject><subject>Biology and Life Sciences</subject><subject>Chronic kidney failure</subject><subject>Clinical medicine</subject><subject>Complications and side effects</subject><subject>Cost control</subject><subject>Cross-sectional studies</subject><subject>Delay</subject><subject>Discharge</subject><subject>Drug therapy</subject><subject>End-stage renal disease</subject><subject>Erythropoiesis</subject><subject>Ferritin</subject><subject>Health aspects</subject><subject>Health care policy</subject><subject>Hematinics</subject><subject>Hemodialysis</subject><subject>Hemoglobin</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Medicine and Health Sciences</subject><subject>Patient compliance</subject><subject>Patient safety</subject><subject>Patients</subject><subject>Pharmacists</subject><subject>Regression analysis</subject><subject>Risk 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One</addtitle><date>2017-11-28</date><risdate>2017</risdate><volume>12</volume><issue>11</issue><spage>e0188390</spage><epage>e0188390</epage><pages>e0188390-e0188390</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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).
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29182650</pmid><doi>10.1371/journal.pone.0188390</doi><tpages>e0188390</tpages><orcidid>https://orcid.org/0000-0002-0029-5924</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adhesion Anemia Biology and Life Sciences Chronic kidney failure Clinical medicine Complications and side effects Cost control Cross-sectional studies Delay Discharge Drug therapy End-stage renal disease Erythropoiesis Ferritin Health aspects Health care policy Hematinics Hemodialysis Hemoglobin Hospitalization Hospitals Kidney diseases Kidney transplantation Medicine and Health Sciences Patient compliance Patient safety Patients Pharmacists Regression analysis Risk factors Therapy |
| title | Predictors of adherence to a new erythropoiesis-stimulating agent inpatient ordering policy: A cross-sectional study |
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