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Kidney Week

Abstract: FR-PO015

Evaluating the Impact of a Tailored Electronic Medication Management System on Anemia Management in Outpatient Hemodialysis Patients

Session Information

Category: Augmented Intelligence, Digital Health, and Data Science

  • 300 Augmented Intelligence, Digital Health, and Data Science

Authors

  • Sheng, Xiaohua, Department of Nephrology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
  • Wang, Niansong, Department of Nephrology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
Background

The prevalence of Medication-related problems (MRPs) in outpatient hemodialysis patients, especially in anemia management, is high. We developed a tailored electronic medication management system for outpatient hemodialysis (the New System) and evaluated its impact on anemia management.

Methods

The New System was collectively developed by our hospital and Spectrum Healthcare, building on the existing electronic information system. We compared the percentage of patients with hemoglobin, ferritin, transferrin saturation within the KDIGO recommended range, and cardiovascular events six months before (control period) and after (study period) the implementation of the New System.

Results

Using the New System, physicians perform evaluations and prescribe medications based on patients' lab reports. After patient payment and pharmacist review, medications are auto-allocated to a virtual pharmacy in the Hemodialysis Center. The New System then generates a medication form before each dialysis session for nursing staff. On dialysis days, the system displays the predetermined prescriptions. After administration by nurses, the system auto-deducts the used medication.
The control period included 285 patients (190 males and 95 females, aged 62.4±13.2 years), and the study period included 278 patients (193 males and 85 females, aged 62.8±13.2 years). Compared with the control period, the percentage of patients at the study period with hemoglobin (40.2% [687/1710] vs 47.8% [797/1668], P<0.001), ferritin (31.2% [178/570] vs 39.0% [217/556], P=0.006), transferrin saturation (58.6% [334/570] vs 64.7% [360/556], P=0.034) within the KDIGO recommended range was higher. The occurrence of cardiovascular events during the study period was 11.2% (31/278), which was lower (P=0.043) compared to the control period where it was 16.5% (47/285).

Conclusion

The implementation of the New System in the Hemodialysis Center improves anemia management in outpatient hemodialysis patients. The study hints that an electronic medication management system tailored for outpatient hemodialysis holds potential in addressing partial MRPs.

Funding

  • Government Support – Non-U.S.