Use of clinical guidelines for treatment of anemia among hemodialysis patients.

Abstract:

:Changing financial incentives have strongly influenced dosing patterns of recombinant human erythropoietin (rHuEPO) since its introduction in 1989. Although guidelines for prescribing rHuEPO exist, the extent to which they are adhered to is unknown. Using a retrospective cohort observational study design, the factors influencing the initial dosing of rHuEPO prescribed to 413 hemodialysis patients in 1994 were examined. Patient weight, the only recommended guideline, was not found to be a significant predictor of dosing of rHuEPO after controlling for selected patient demographic and clinical characteristics. The strongest predictor for initial rHuEPO dosing was hematocrit followed by White race (p < 0.05). Finally, each subsequent month was associated with a significantly larger initial rHuEPO dose, reflecting the general trend in increasing dose since 1991 (p < 0.001). In conclusion, despite the recent DOQI guidelines for treatment of anemia among persons with chronic renal failure, providers are not using patient weight as an independent criterion for determining dosing of rHuEPO.

journal_name

Artif Organs

journal_title

Artificial organs

authors

Thamer M,Richard CM,Klinkmann J,Ivanovich P,Lang G,Cotter DJ

doi

10.1046/j.1525-1594.2000.06495.x

subject

Has Abstract

pub_date

2000-02-01 00:00:00

pages

91-4

issue

2

eissn

0160-564X

issn

1525-1594

pii

aor6495

journal_volume

24

pub_type

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