ABSTRACT
OBJECTIVE: To assess an interdisciplinary programme for the improvement of pharmacotherapy quality and patient safety in patients with chronic renal disease who are treated with erythropoiesis-stimulating agents. METHOD: Observational, longitudinal study. Retrospective analysis (period A) and prospective analysis (period B) following implementation of the programme for haemoglobin values and monthly erythropoiesis-stimulating agent dosage. The proportion of patients with haemoglobin values within the target range (10-5-12.5 g/dl) and those with values above the safety limit (>or= 12.5g/dl) were compared every four months and the average percentage of time with haemoglobin values within the target range and above the safety limit were compared during periods A and B. RESULTS: 59 patients were included in the study. The proportion of patients with haemoglobin levels within the target range increased from 28.8% to 65.4% (RR = 2.27; 95% CI, 1.56-3.30) and the value in patients with haemoglobin levels above the safe level reduced from 57.6% to 19.2% (RAR = 0.39; 95% CI, 0.19-0.55). The time with haemoglobin levels in the target range increased 15.7% (95% CI, 7.1-24.2) and the time with values above the safe level reduced 26.9% (95% CI, -35.1 to -18.6). The number of patients included to avoid one reaching a haemoglobin value above the safe range was 2.6 (95% CI, 2.5-2.7). CONCLUSIONS: the implementation of an improvement programme for the quality of pharmacotherapy with erythropoiesis-stimulating agents in patients with haemodialysis significantly increases the proportion of patients with haemoglobin values within the recommended ranges of effectiveness and safety.
