Pharmacy World & Science

, 29:7 | Cite as

Assessing a pharmacist-run anaemia educational programme for patients with chronic renal insufficiency

  • B. AllenetEmail author
  • C. Chen
  • T. Romanet
  • P. Vialtel
  • J. Calop
Short Research Report


Objective: Assessment of a pharmacist-run anaemia educational programme for patients with chr-onic renal insufficiency. Setting: Nephrology Department, Grenoble Hospital, France Method: A 12-week prospective study, using a before–after intervention design. Included in the study were predialysis outpatients with a haemoglobin level < 10 g/dl, de novo EPO prescription; judged qualified by the nephrologist for self-injections; accepting self-injections. The intervention was a single one-hour individual session between the pharmacist and the patient to target (1) medical and therapeutic information; (2) information on the device, a pen used with a cartridge of beta epoietin; (3) training with the pen; and (4) self-injection of the first dose by the patient, in front of the pharmacist. Main outcome measures were knowledge (7-item questionnaire); handling skills (observation) and Quality of Life (1 Likert scale on apprehension towards self-injections and 3 Linear Analog Scales on energy, daily activities, and general well-being); compliance (self-report on self-administered injections) and haemoglobin level. Results: Ten patients were followed for 3 months after intervention. The evolution of the knowledge was positive but not statistically significant after the programme (80% of good answers before; 93% 3 months later). Concerning the patients’ skills, difficulties with the pen were important at inclusion, (1) to reset the pen into zero position (2.8 tries/patient ±1.8); (2) to insert a new cartridge (1.9 ± 1.1); and (3) to take air out of the cartridge (2.3 ± 1.2). After the session, results were satisfactory, since 3 months later, all patients were still on self-injections. QoL improved significantly over the study period respectively on energy, daily activities, and general well-being. The mean level of compliance remained above 90% at 3 months for 8 out of 10 patients. Patients reached the haemoglobin target value of 11 g/dl during the second month of treatment. Conclusion: A tailored educational programme conducted by a pharmacist is beneficial for anaemia patients with chronic renal insufficiency. The programme seems to result in a high level of compliance, leading to an optimal haemoglobin level within two months.


Patient education Erythropoietin Chronic renal insufficiency Haemoglobin level Compliance Clinical pharmacist 


  1. 1.
    Radermacher J and Koch KM (1995). The treatment of renal anaemia by erythropoietin substitution. The effects on the cardiovascular system. Clin Nephrol 44(Suppl 1): S56–S60PubMedGoogle Scholar
  2. 2.
    Robertson HT, Haley NR, Guthrie M, Cardenas D, Eschbach JW and Adamson JW (1990). Recombinant erythropoietin improves exercise capacity in anemic hemodialysis patients. Am J Kidney Dis 15(4): 325–332PubMedGoogle Scholar
  3. 3.
    Valderrabano F (2000). Quality of life benefits of early anaemia treatment. Nephrol Dial Transplant 15(Suppl 3): 23–28PubMedGoogle Scholar
  4. 4.
    Fink J, Blahut S, Reddy M and Light PW (2001). Use of erythropoietin before the initiation of dialysis and its impact on mortality. Am J Kidney Dis 37(2): 348–355CrossRefPubMedGoogle Scholar
  5. 5.
    Jungers P, Choukroun G, Oualim Z, Robino C, Nguyen AT and Man NK (2001). Beneficial influence of recombinant human erythropoietin therapy on the rate of progression of chronic renal failure in predialysis patients. Nephrol Dial Transplant 16(2): 307–312CrossRefPubMedGoogle Scholar
  6. 6.
    Nicoletta P, Bernardini J, Dacko C and Fried L (2000). Compliance with subcutaneous erythropoietin in peritoneal dialysis patients. Adv Perit Dial 16: 90–92PubMedGoogle Scholar
  7. 7.
    Wazny LD, Stojimirovic BB, Heidenheim P and Blake PG (2002). Factors influencing erythropoietin compliance in peritoneal dialysis patients. Am J Kidney Dis 40(3): 623–628CrossRefPubMedGoogle Scholar
  8. 8.
    Golper T (2001). Patient education: can it maximize the success of therapy?. Nephrol Dial Transplant 16(Suppl 7): 23–24Google Scholar
  9. 9.
    Weiss L (2002). A rationale for an individualized administration frequency of epoetin beta: a clinical perspective. Nephrol Dial Transplant 17(Suppl 6): 8–12CrossRefPubMedGoogle Scholar
  10. 10.
    Gabrilove J, Cleeland C and Livingston R (2001). Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in haemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol 19(11): 2875–2882PubMedGoogle Scholar
  11. 11.
    Working party for European best practice guidelines for the management of anaemia in patients with chronic renal failure. Nephrol Dial Transplant 1999; 14(Suppl 5):1–50Google Scholar
  12. 12.
    Frankenfield DL and Johnson CA (2002). Current management of anaemia in adult hemodialysis patients with end-stage renal disease. Am J Health-Syst Pharm 59(5): 429–435PubMedGoogle Scholar
  13. 13.
    Linh L, Stoner CP, Stolley SN, Buenviaje JD and Ziegler TW (2001). Effectiveness of a pharmacist-implemented anaemia management protocol in an outpatient hemodialysis unit. Am J Health-Syst Pharm 58(21): 2061–2065Google Scholar
  14. 14.
    Leger S, Allenet B, Pichot O, Figari G, Calop J, Carpentier P and Bosson JL (2004). Impact of an education program on patient behavior favoring prevention of drug-related adverse events: a pilot study in patients receiving oral anticoagulants for thromboembolic venous disease. J Mal Vasc 29(3): 152–158CrossRefPubMedGoogle Scholar
  15. 15.
    Ruiz Gallar P, Balcke P and Montenegro Martinez J (2000). Tolerability of the epoetin-beta multidose formulation (Reco-Pen®) in patients with renal anaemia. Clin Drug Invest 20(3): 151–158CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • B. Allenet
    • 1
    • 6
    Email author
  • C. Chen
    • 2
  • T. Romanet
    • 3
  • P. Vialtel
    • 4
  • J. Calop
    • 5
  1. 1.Département de Pharmacie, Pavillon MoidieuCHU de GrenobleGrenoble Cedex 9France
  2. 2.Clinical Pharmacy Resident, Department of PharmacyGrenoble Teaching HospitalGrenobleFrance
  3. 3.Clinical Nephrology Pharmacist, Department of PharmacyGrenoble Teaching HospitalGrenobleFrance
  4. 4.Head of Department of NephrologyGrenoble Teaching HospitalGrenobleFrance
  5. 5.Head of Department of PharmacyGrenoble Teaching HospitalGrenobleFrance
  6. 6.Clinical Pharmacist, Senior lecturer in Clinical Pharmacy, ThEMAS TIMC-IMAG (UMR CNRS 5525), Université J. Fourier, Department of PharmacyGrenoble Teaching HospitalGrenobleFrance

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