02163nas a2200193   4500000000100000008004100001100001400042700001600056700001500072700001100087700001300098700001700111700001400128700001400142245009400156250001800250520165400268020004701922       2013                            d1 aCass Alan1 aSnelling P.1 aMacleod A.1 aLan P.1 aCraig J.1 aGallagher M.1 aKotwal S.1 aJardine M00aComparative efficacy of a team-led treatment protocol for the management of renal anaemia  a31 July 2013.3 a<p>
AIM: To evaluate the efficacy of a team led anaemia management protocol based on current guidelines. METHODS: The effect of a treatment protocol in implementing an anaemia guideline was evaluated in a large teaching hospital, encompassing three (two in-hospital and one satellite) dialysis facilities. Quarterly data were collected, over a 6-year period, on all patients dialysing in these facilities, before and after implementation of an anaemia management treatment protocol. This protocol was developed by a physician led team and implemented by an anaemia co-ordinator assisted by the unit staff. The primary outcome measure was the proportion of patients receiving erythropoietin with ferritin levels within the national guidelines target range calculated using data on haemoglobin (Hb), iron studies, dry weight and erythropoietin dose. RESULTS: Data was collected on &gt;150 patients every quarter between 2005 and 2010 (inclusive). The proportion of patients within the primary outcome target range increased from a nadir of 17% to 51% with evidence of true systematic change. The proportion of patients with Hb values within the unit target range also increased from 46% to 56% (p=0.25) between the first and last years of the project. These changes were also associated with reduced erythropoietin drug use down to 0.44 mug/kg/week. CONCLUSION: Implementation of a treatment protocol for anaemia management in haemodialysis patients was associated with greater consistency with guideline evidence and lower drug use. Achieving such guideline recommendations for ferritin targets in more than 50% of patients appears feasible.
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