Abstract

A STUDY ON THE ANALYSIS OF PRESCRIBING PATTERN, SAFETY AND EFFECTIVENESS OF IRON-ERYTHROPOIETIN COMBINATION OVER ERYTHROPOIETIN MONOTHERAPY IN CHRONIC KIDNEY DISEASE PATIENTS WITH HAEMODIALYSIS

Abhija R.V.*, Julia Mariam John, Nicy T. Joseph, Deepti Mathew, Satheesh Balakrishnan, Sreekavya B. and Santhosh M. Mathews

ABSTRACT

Treatment of anaemia in chronic renal failure with exogenous recombinant human erythropoietin (rHuEpo) is well established. The objective of this prospective observation study was to evaluate anemia management protocol in haemodialysis patient using intravenous erythropoietin and iron. The sample population were patients with CKD undergoing haemodialysis. A total of 110 patients were supposed to be included with in the study, with 55 each for erythropoietin monotherapy and for combined erythropoietin and iron therapy. Due to COVID 19 pandemic situation only a sample size of 80 were achieved from which 40 of them were under erythropoietin monotherapy (control) and remaining 40 of them were administered with both erythropoietin and iron together(test). The primary outcome was proportion of patient on combined therapy of iron and erythropoietin achieved normal haemoglobin values more rapidly (p= 0.000008 for Group 1 and p= 0.00002 for group 2). A non-significant decrease on erythropoietin dose was observed in 17.5% of patients receiving both erythropoietin and iron together, while 20% of patients among those receiving erythropoietin monotherapy was observed with increased dose of erythropoietin. Combination therapy provided a remarkable increase in quality-of-life enjoyment and satisfaction to the patient. Upon prescribing pattern analysis cardiovascular drugs contributed most to the prescription while genitourinary drugs and respiratory system drugs were the least prescribed ones. Hypertension was the most prominent side effect that almost 85% of total study population experienced followed by weakness, headache, and shortness of breath. Upon medication adherence evaluation 7% of people were observed with high adherence level and 5% of them with the least adherence. The study demonstrated that the combined use of iron and erythropoietin in patient with CKD undergoing haemodialysis may result in comparable Hb levels, reduced erythropoietin dose requirement and improved quality of life of the patient

Keywords: Haemodialysis, Erythropoietin, Medication adherence, Genitourinary, Hypertension.