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CP-198 Review of intravenous iron prescriptions: focus on dosing
  1. G Morla,
  2. N Pons,
  3. J Altimiras,
  4. P Marcos,
  5. M Sanmartin,
  6. G Baronet,
  7. M Nevot,
  8. M Bayona,
  9. M Ventura
  1. Quiron Hospital Universitari General de Catalunya, Pharmacy, Sant Cugat del Valles, Spain

Abstract

Background Ferric carboxymaltose (Ferinject) is included in our drug formulary for patients in need of rapid iron replacement. Iron replacement is usually calculated using the Ganzoni formula. Haemoglobin (Hb) values should be reassessed in 4 weeks

Purpose To compare the dose of iron prescribed with the dose recommended in the Ganzoni formula and to assess Hb values after iron therapy.

Material and methods This was a retrospective descriptive study in a 350 bed tertiary level hospital. From October 2015 to January 2016, all patients receiving intravenous iron therapy were analysed. Gender, age, weight, Hb and ferritin before intravenous iron infusion and post infusion, intravenous iron dose prescribed, treatment indication and prescriber’s clinical specialty were recorded for each patient. Iron deficiency was calculated using Ganzoni’s formula.

Results During the study period, 64 patients were treated with intravenous iron therapy, 59% were women and the average age was 60 years. Internal medicine was the main clinical specialty with 62% of the total cases, with anaemia the main indication, followed by gynaecology with 16% of patients and postpartum haemorrhage diagnosis. According to Ganzoni’s formula, only 17% received the dose required based on calculated iron deficiency. Most of these patients had a diagnosis of anaemia and iron was prescribed by the internal medicine service. 83% received a different dose from the Ganzoni formula (70% lower dose and 13% higher dose). Average Hb pre infusion was 9 g/dL (n=59) and ferritin 104.3 ng/mL (only obtained in 36% of patients). Average Hb post infusion was 10.5 g/dL (36% of patients).

Conclusion This study showed that doses prescribed did not correspond to Ganzoni’s formula, and that most patients received lower doses. Values for Hb post iron therapy could not be found in most patients and were below the recommended target values. These results highlight the need to create a protocol to ensure correct dosing of intravenous iron and to improve patient safety.

References and/or acknowledgements Auerbach M, Ballard H, Glaspy J. Clinical update: intravenous iron for anaemia. Lancet2007;369:1502–4.

Goddadrd AF, James MW, McIntyre AS, et al. Guidelines for the management of iron deficiency anaemia. Br Soc Gastroenterol2005. Available at: http://www.bsg.org.uk/bsgdisp1.php?id=5fcf2c23ecffd7c605c9&h=1&sh=1&i=1&b=1&m=00023

Ficha técnica Ferinject: http://www.vademecum.es/medicamento-ferinject_32319

No conflict of interest

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