Pharmacist-assisted protocol optimizes iron therapy dosing for anaemic patients

A recent study has shown the success of a pharmacist-assisted iron sucrose total dose infusion (TDI) protocol in increasing serum haemoglobin among patients with iron deficiency anaemia (IDA). In addition, the protocol is well-tolerated, with no incidence of anaphylaxis reported.

An iron sucrose TDI was implemented at a tertiary hospital with staff pharmacists aiding physicians in appropriate dosing. The investigators then conducted a retrospective chart review to define the safety and efficacy of such protocol in adults with IDA.

Patients aged ≥18 years who were hospitalized and received iron sucrose in doses ≥300 mg were included in the analysis. Medical records were reviewed for adverse reactions to any TDI of iron sucrose as well as pre- and post TDI haemoglobin levels to assess efficacy.

During the study period, 238 patients (mean age 60.6 years, 81 percent female) were given iron sucrose TDI for IDA. Mean pre-TDI haemoglobin was 8.76 g/dL, and the mean total dose of iron sucrose in the entire cohort was 680 mg (range, 300–2,500 mg).

Fifteen patients reported adverse effects associated with iron sucrose, with nausea being the most common (n=7, 2.9 percent). A haemoglobin increase of 2.1 g/L was observed when matching patients’ pre- and postadmission records (p<0.001).

Notably, there was no increase in liver function tests seen in any patient.

“Intravenous iron therapy for patients with IDA is safe and effective in restoring haemoglobin concentration rapidly,” the investigators said. “Pharmacist-assisted protocols can aid in optimal dosing of this therapy [for] improving outcomes.”