Journal of Pharmacy Technology最新文献

{"title":"Outcomes of Hospitalized Patients With Sepsis Before and After Implementation of a Sepsis Care Improvement Initiative at a Community Hospital.","authors":"Kenneth J Richardson, Chanda L Mullen, Gretchen L Sacha, Erik M Wasowski","doi":"10.1177/87551225241283193","DOIUrl":"10.1177/87551225241283193","url":null,"abstract":"<p><p><b>Purpose:</b> Prompt treatment of sepsis and septic shock is critical as delays increase mortality risk. Various tools, such as electronic alerts, standardized order sets, and rapid response teams, are used to expedite sepsis bundled care, yet their individual effects on outcomes and antimicrobial timing are unclear. This study evaluated the impact of an Inpatient Code Sepsis protocol, featuring an overhead page and order set, on mortality in hospitalized patients with sepsis and septic shock. <b>Methods:</b> A retrospective cohort study was conducted at a 371-bed hospital from July 1, 2020, to July 31, 2023. Hospitalized adults (≥18 years) diagnosed with sepsis and septic shock before and after the Inpatient Code Sepsis protocol implementation were included. The primary outcome was 30-day all-cause mortality; secondary outcomes were hospital length of stay, 30-day readmission, and time to antibiotic administration. Patients were excluded if they were identified for sepsis without infection, had sepsis due to non-bacterial causes, lost to follow-up within 30 days of admission, received empiric antibiotics in an emergency department or outside hospital, or were missing antibiotic administration time. <b>Results:</b> A total of 138 patients were included in the analysis. Mortality within 30 days did not significantly differ preprotocol and postprotocol (<i>p</i> = 0.381). However, a significant reduction in time to antibiotic administration was noted postimplementation (<i>p</i> < 0.05). Hospital length of stay and 30-day readmission showed no significant changes. <b>Conclusion:</b> The Inpatient Code Sepsis protocol did not impact 30-day mortality but did improve the time to antibiotic administration.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"40 6","pages":"263-268"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"Weight\" for a New Agent Is Almost Over: A Commentary on the Novel Triagonist Retatrutide for Obesity.","authors":"Maryam Deravi, Chris Piszczatoski, Bradley Phillips, Jessica Huston, Angelina Vascimini","doi":"10.1177/87551225241285326","DOIUrl":"10.1177/87551225241285326","url":null,"abstract":"<p><p>Retatrutide, a hormone receptor agonist targeting glucagon, glucagon-like peptide 1, and glucose-dependent insulinotropic polypeptide, is being developed to treat obesity. A literature review from April 2019 to April 2024 included such terms as \"retatrutide,\" \"LY3437943,\" \"overweight,\" and \"obesity.\" Phase I proof-of-concept studies led to phase II trials showing up to 24% body weight reduction and nearly 20 cm waist circumference reduction. The most common adverse effects were gastrointestinal. Ongoing phase II and III studies aim to further evaluate the safety and efficacy of retatrutide as a novel triagonist for obesity treatment.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"40 6","pages":"300-305"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Effects Associated With Multimodal Analgesic Regimens in Critically Ill, Nonintubated Patients: A Systematic Review and Meta-Analysis.","authors":"Justin P Reinert, Wade Lee-Smith, Cole Jerousek","doi":"10.1177/87551225241277450","DOIUrl":"10.1177/87551225241277450","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the safety of utilizing multimodal analgesic regimens in critically ill, nonintubated patients. Data Sources: A systematic review was conducted using Embase, MEDLINE, Cochrane, SciELO, Web of Science, and the Korean Journal Index. Clinical trials of critically ill, nonintubated patients that contained complete safety outcomes date, including the incidence of specific adverse drug effects (ADE) associated with a multimodal analgesic medication or regimen, were included. <b>Study Selection and Data Extraction:</b> The primary outcome was the incidence of adverse drug effects associated with multimodal analgesics in comparison to standard-of-care analgesic strategies in our patient population. The secondary outcome was a subgroup analysis of adverse drug effect by type and by medication. <b>Data Synthesis:</b> 10 trials were included in this systematic review, of which 6 were randomized control trials that were evaluated in the meta-analysis. There was no statistically significant difference with respect to the primary outcome (mean difference = -0.11, <i>P</i> = 0.31, 95% CI = [-0.35, 0.13]). The subgroup analysis, which was conducted on randomized clinical control trials that documented a single adjunctive analgesic rather than a multimodal regimen, was stratified by the type of adverse effect encountered and the medication in question. There were no statistically significant findings regarding the incidence of specific ADE. Nonrandomized data included in this study support these findings. Conclusions: While concerns of the additive deleterious adverse effects commonly encountered in polypharmacy are valid, our findings support the use of multimodal analgesic regimens in the provision of analgesic in critically ill, nonintubated patients.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"40 6","pages":"287-295"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Sampling Errors in Stability Studies Due to Dead Volume in Closed System Transfer Devices.","authors":"Mélanie Closset, Maire-Lise Colsoul, Benoît Bihin, Jean-Daniel Hecq, Pascal Odou, Laurence Galanti","doi":"10.1177/87551225241285319","DOIUrl":"10.1177/87551225241285319","url":null,"abstract":"<p><strong>Background: </strong>Closed system transfer devices (CSTD) help to reduce the exposure of healthcare professionals to hazardous drugs. They may be used in stability studies conducted on anticancer drugs. During a stability study about polyolefin bags of gemcitabine, Tevadaptor® device was suspected of causing a bias in the evaluation of the concentrations of the first aliquots extracted from the bags.</p><p><strong>Objective: </strong>The objectives are to determine whether the use of a CSTD to prepare a drug solution and to withdraw it from a bag can interfere on the measured concentration compared to the expected one and to suggest hypothesis to explain the phenomenon.</p><p><strong>Method: </strong>In the first experiment, three polyolefin bags of gemcitabine (5.4 mg/mL) were prepared under aseptic conditions using the Tevadaptor Luer Lock Adaptor®. The day of preparation, five aliquots of 3.8 ml each were sequentially withdrawn from each polyolefin bag using the same device. After one day, a new aliquot was withdrawn from each bag. In the second experiment, three polyolefin bags of gemcitabine (5.4 mg/ml) were prepared under aseptic conditions using a needle. One aliquot was extracted using a needle after the preparation from each bag, and another aliquot was extracted after one day. The concentrations of all aliquots were measured by liquid chromatography coupled to a photodiode array detector during the same run.</p><p><strong>Results and discussion: </strong>The concentrations of the first aliquots extracted on day zero from the polyolefin bags using the Tevadaptor Luer Lock Adaptor® exhibit an overestimation of 26% ([95%CI: 23%-29%] P<0.001) compared to the others. Overestimation is not found for subsequent aliquots, or while using a needle to bypass the Tevadaptor® device.</p><p><strong>Conclusion: </strong>This case highlights the bias that may arise when using CSTDs in stability studies. They should be used with comprehensive understanding of their technical specifications.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"40 6","pages":"296-299"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and Evaluation of APOTECAchemo in a Community Cancer Center: A Comparative Study of Robotic Versus Manual Antineoplastic Preparation.","authors":"Han Na Cho, Lyn Wells, Zachery Halford","doi":"10.1177/87551225241278203","DOIUrl":"10.1177/87551225241278203","url":null,"abstract":"<p><p><b>Background:</b> The ever-increasing complexity and demand for antineoplastic therapy necessitates innovative solutions to improve the accuracy and safety of drug preparation. <b>Objective:</b> To evaluate the utilization of an advanced robotic chemotherapy drug compounding system (APOTECAchemo) at a Community Cancer Center (CCC), examining accuracy, efficiency, and staff perceptions. <b>Methods:</b> This single-center, retrospective study evaluated the preparation of 7 intravenous (IV) antineoplastics at a CCC over a 1-year period. We compared manual methods with the APOTECAchemo system. The primary measure of accuracy was the absolute drug error percentage, with a comparison of pass and fail rates. Secondary endpoints included the overall use of APOTECAchemo for all IV antineoplastic preparations and average preparation times. An end-user satisfaction survey gathered feedback from pharmacists and pharmacy technicians. <b>Results:</b> A total of 8210 doses were prepared at the CCC, with 52.1% compounded by APOTECAchemo and 47.9% manually. Of these, the CCC prepared 5526 doses of the 7 routinely compounded antineoplastics. APOTECAchemo prepared 3851 (69.7%) doses, while manual compounding accounted for 1675 (30.3%) doses. The average absolute drug error was 1.44% (95% CI, 1.35-1.53) with robot compounding versus 1.17% (95% CI, 1.03-1.32) with manual (<i>P</i> < 0.001). The overall failure rate was 0.72%. There were 25 failed doses (0.45%), with 8 (0.2%) failures attributed to APOTECAchemo and 17 (1%) to manual compounding (<i>P</i> < 0.001). The average dose preparation time was longer with APOTECAchemo compared with manual methods. The end-user satisfaction survey indicated a positive reception toward APOTECAchemo. <b>Conclusions:</b> Our study demonstrates the successful implementation, extensive utilization, and high accuracy of both APOTECAchemo and manual compounding methods in the preparation of routinely administered antineoplastics at a CCC.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"40 6","pages":"269-276"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Computerized Prescriber Order Entry Systems: A Review of Impacts, Barriers, and Facilitators.","authors":"Ian Farrugia, Patricia Vella Bonanno","doi":"10.1177/87551225241284919","DOIUrl":"10.1177/87551225241284919","url":null,"abstract":"<p><strong>Objective: </strong>This review evaluated the impact of a digitized computerized prescriber order entry (CPOE) system and described barriers and facilitators for introducing a digitized system.</p><p><strong>Data sources: </strong>A systematic literature search was conducted in PubMed, Medline, and CINAHL using keywords. Articles in English during the last 10 years were included.</p><p><strong>Study selection and data extraction: </strong>Study selection was presented using a PRISMA flow diagram. Forty-eight studies were included. Data from the articles were presented to address each of the three objectives.</p><p><strong>Data synthesis: </strong>CPOE systems improved the quality of care provided but also introduced new types of errors. Facilitating factors for implementation included leadership, stakeholder engagement, training, and user-centered design. Inadequate training, software design, changes in workload, and workflow disruptions were identified as barriers. Recommendations for implementation included dedicated training of users, user-centered design, a backup for system downtimes, and stakeholder engagement.</p><p><strong>Conclusion: </strong>Application of knowledge of the facilitators and barriers for the introduction of a CPOE system supports this change-management process within the specific context and augurs for more successful implementation.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":"40 6","pages":"277-286"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Heparin Quality Assurance Utilizing Electronic Data Abstraction.","authors":"Elizabeth Lemanske, Justin Zimmerman, Paul Dobry, Stephanie Edwin, Christopher Giuliano","doi":"10.1177/87551225241299691","DOIUrl":"10.1177/87551225241299691","url":null,"abstract":"<p><p><b>Background:</b> Heparin is a high-risk medication with significant variability across patients. Systematic data analysis can help hospitals improve heparin management, ensuring safe and effective anticoagulation. An opportunity exists to create a more efficient data collection process, allowing hospitals to streamline quality assurance programs. <b>Objective:</b> To assess the agreement between manual and electronic data abstraction for heparin quality assurance. <b>Methods:</b> This is a single-center, observational cohort study that evaluated patients who received therapeutic unfractionated heparin from September to November 20, 2023. Patients treated for less than 24 hours were excluded. Data were collected manually from pharmacist monitoring forms and the electronic medical record; electronic data abstraction was queried from an institutional data warehouse. The primary outcome was agreement in percentage of patients achieving a therapeutic aPTT within 24 hours. Secondary outcomes included agreement on time to therapeutic aPTT, agreement on time to therapeutic or supratherapeutic aPTT, and clinical outcomes. <b>Results:</b> The study included 288 patients. Manual data collection indicated 44.1% of patients were therapeutic within 24 hours, whereas electronic data collection showed 46.9% (kappa = 0.86). The kappa value for agreement of therapeutic or supratherapeutic aPTT within 24 hours was substantial (kappa = 0.69), with manual data showing 61.5% of patients therapeutic within 24 hours compared with 73.3% in electronic data. However, poor agreement was found when identifying subsequent heparin boluses (kappa = 0.13) and new venous thromboembolism cases (kappa = -0.01). <b>Conclusions and Relevance:</b> The metrics from the 2 data collection methods varied in reliability, ranging from highly consistent to poorly aligned. A hybrid approach, integrating manual and reliable electronic methods, has been implemented at our institution to improve efficiency. Further studies are needed to assess generalizability, and enhance electronic data capture for clinical outcomes.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"87551225241299691"},"PeriodicalIF":1.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11574770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of Randomized Controlled Trials Examining Prescription and Nonprescription Pharmacological Interventions for Moderate to Severe Traumatic Brain Injury.","authors":"Sarvenaz Mehrabi, Cecilia Flores-Sandoval, Robert Teasell, Heather M MacKenzie, Maria Kurian, Emma A Bateman","doi":"10.1177/87551225241296420","DOIUrl":"10.1177/87551225241296420","url":null,"abstract":"<p><p><b>Objective:</b> To characterize randomized controlled trials (RCTs) of pharmacological interventions (prescription medications, nonprescription medications, and supplements) for the management of moderate to severe traumatic brain injury (MSTBI). <b>Data sources:</b> Systematic searches were conducted in MEDLINE, PubMed, Scopus, CINAHL, EMBASE, and PsycINFO for RCTs up to December 2022 inclusive in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. <b>Study selection and data extraction:</b> Inclusion criteria were RCT study design; participants' mean age ≥ 18 years and ≥ 50% had MSTBI; examined ≥ 1 pharmacological intervention(s), either alone or in combination with other interventions. Two independent reviewers conducted Cochrane risk of bias assessment. <b>Data synthesis:</b> Three hundred thirteen RCTs (1978-2022) met inclusion criteria. A total of 146 unique pharmacotherapies and supplements were studied. The most frequently studied intervention was mannitol (<i>n</i> = 20 RCTs). Mean sample size was 230.4 (4-12 737) and 195 studies (62.3%) were conducted in the acute phase post-MSTBI. Four hundred thirty-five unique outcome measures (OMs) were studied; the most common OMs used were Glasgow Outcome Scale (GOS) (29.4%), mortality (25.2%), and intracranial pressure (25.2%), Glasgow Coma Scale (GCS) (19.5%), and mean arterial pressure (17.3%), and heart rate (10%). Of the included studies, only 7% (<i>n</i> = 22) had low risk of bias. <b>Conclusion:</b> The paucity of high-quality studies, variability in RCT methodology, sample sizes, and OMs utilization, as well as the low number of RCTs conducted in the subacute- and chronic-phase after injury pose a challenge for conducting meta-analyses to provide strong recommendations for informed decision-making in clinical practice.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"87551225241296420"},"PeriodicalIF":1.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Comparison of Oral Versus Injectable Semaglutide for the Reduction of Hemoglobin A_1C and Weight in Patients with Type 2 Diabetes.","authors":"Maria Pinto, Lillian Brennan, Katie Diehl, Shally Lin, Samantha Heacock","doi":"10.1177/87551225241289959","DOIUrl":"10.1177/87551225241289959","url":null,"abstract":"<p><strong>Background: </strong>No head-to-head comparisons of semaglutide formulations currently exist in the literature. In practice, many may think that oral and injectable semaglutide formulations are interchangeable, although there is currently limited real-world data to determine whether this is accurate.</p><p><strong>Objective: </strong>The purpose of this study was to determine the effect of oral versus injectable semaglutide on hemoglobin A_1C (HbA_1C) and weight in patients with type 2 diabetes (T2D).</p><p><strong>Methods: </strong>This was a retrospective single-center review of adult patients who had a diagnosis of T2D and were treated with oral or injectable semaglutide between November 1, 2019, and July 31, 2022. Primary outcome was a comparison of changes in HbA_1C (%) and weight (kg) from baseline to 6 months between patients receiving oral versus injectable semaglutide, stratified according to highest dose received. Secondary outcomes included frequency of dose reductions and discontinuations, achievement of clinical goals, and presence of an embedded clinical pharmacist at patients' primary care office.</p><p><strong>Results: </strong>A total of 105 patients were included. Patients experienced mean decreases in HbA_1C and weight from baseline to 6 months of -1.75% (<i>P</i> < 0.001) and -3.64 kg (<i>P</i> = 0.015), respectively, in the oral semaglutide group and -1.35% (<i>P</i> < 0.001) and -5.26 kg (<i>P</i> < 0.001), respectively, in the injectable semaglutide group. When directly comparing semaglutide formulations, oral semaglutide demonstrated a 0.4% greater numerical reduction in HbA_1C (<i>P</i> = 0.523) and injectable semaglutide demonstrated a 1.62-kg greater numerical reduction in weight (<i>P</i> = 0.312). Adverse events (AEs) occurred more frequently with oral semaglutide than with injectable semaglutide (16.7% vs 4.9%). Discontinuation due to AEs was more common with oral semaglutide.</p><p><strong>Conclusion: </strong>In this study, patients with T2D who received oral semaglutide demonstrated greater reductions in HbA_1C, whereas those treated with injectable semaglutide had greater reductions in weight, although there were no statistically significant reductions in HbA_1C or weight between the 2 formulations. Rates of AEs and discontinuation were more common in the oral semaglutide group.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"87551225241289959"},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of an Accelerated Ferric Gluconate Inpatient Infusion Regimen.","authors":"Erica Gray, Tate Parrott, Lauren McCluggage","doi":"10.1177/87551225241288144","DOIUrl":"10.1177/87551225241288144","url":null,"abstract":"<p><strong>Background: </strong>Inpatient use of intravenous iron has been increasing. Ferric gluconate is traditionally given once daily. Twice-daily dosing provides faster iron repletion, but there are limited data to support the safety of twice-daily dosing.</p><p><strong>Objective: </strong>The aim of this study was to investigate the safety of twice-daily dosing for ferric gluconate compared with daily dosing.</p><p><strong>Methods: </strong>This was an institutional review board-approved retrospective observational study of hospitalized adult patients who received intravenous ferric gluconate 250 mg daily or twice daily between January 1 and April 3, 2022. The primary composite safety outcome included hypotension, infusion reaction, rapid response alert, or escalation in level of care. Secondary outcomes included total amount of iron received, hospital length of stay, and changes in laboratory values.</p><p><strong>Results: </strong>A total of 126 patients were included in this study, with 63 patients in each group. The primary outcome occurred in 29 patients (46%) in the twice-daily group compared with 36 patients (57.1%) in the daily group (relative risk = 0.81; 95% CI, 0.57-1.13; <i>P</i> = 0.212). Changes in iron, hemoglobin, and transferrin saturation were similar between the 2 groups. Median length of stay was statistically shorter in the twice-daily group (7.79 days) compared with the daily group (12.9 days; <i>p</i> = 0.006).</p><p><strong>Conclusions: </strong>In this retrospective single-center study of hospitalized adult patients, those who received intravenous ferric gluconate twice daily did not experience an increased rate of a composite safety outcome of hypotension, infusion reactions, or escalation in level of care compared with those with daily dosing.</p>","PeriodicalId":16796,"journal":{"name":"Journal of Pharmacy Technology","volume":" ","pages":"87551225241288144"},"PeriodicalIF":1.1,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}