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Drug supply/logistics (including: computeraided drug dispatching and ward pharmacies)
Erythropoesis-stimulating agents – study of their use in cancer patients
  1. B. Rodríguez Vargas,
  2. T. Gallego Aranda,
  3. A. Aranguren Oyarzábal,
  4. A. Ibáñez Zurriaga,
  5. C. Martínez Nieto,
  6. M. Pérez Abanades,
  7. A. Morell Baladron
  1. 1Hospital La Princesa, Pharmacy, Madrid, Spain

Abstract

Background Anaemia is common, occurring in 30-90% of cancer patients. Erythropoiesis Stimulating Agents (ESAs) have shown to be effective in the correction of anaemia in oncohaematology.

Purpose To assess the use of ESAs in cancer patients and the adherence to the 2011 ASCO guidelines on the use of epoetin and darbepoetin in adult patients with cancer.

Materials and methods A retrospective study into the use of ESAs in cancer patients was performed over nine months. Patients were located by reviewing the dispensing records supplied by the unit dose and outpatient software in the pharmacy department. Data collected were: age, sex, diagnosis, chemotherapy schedule, ESA dosage, haemoglobin level at baseline and after 6 to 8 weeks. The degree of adherence to guidelines was assessed for the items: anaemia related to chemotherapy, haemoglobin <10 g/dl before ESA, continuing treatment beyond 6–8 weeks in the absence of response (1–2 g/dl increase in Hb).

Results 82 patients were included (61% female), mean (±SD) age was 62±18. The most common cancer locations were lung and breast. The most common chemotherapeutic agents were carboplatin and paclitaxel. 7 patients were treated with epoetin 30000 IU weekly, and 75 with darbepoetin (5.3% 150 mcg weekly or 94.7% 500 mcg every 3 weeks). Titration was performed only for one patient and the drug was changed for two patients. The mean (±SD) baseline haemoglobin was 9.93±0.56 mg/dl. Response was obtained in 53.6% of patients. Degree of adherence: 95.1% of patients were treated with chemotherapy, baseline haemoglobin was <10 g/dl in 56% of patients and 17% continued treatment in the absence of response.

Conclusions The ESA most commonly used was darbepoetin 500 mcg every 3 weeks. ESAs were effective in half of patients. In accordance with guidelines most patients had concomitant chemotherapy. However pharmacists face an important challenge in seeking to improve other aspects that have been evaluated.

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