A Review of the Appropriate Usage and Efficacy of Iron Replacement Therapy in Gastroenterology Inpatients: Is Intravenous Iron Overutilized?

• Author / Creator

  Li, Suqing

• Background:
  Iron deficiency anemia (IDA) is highly prevalent in patients with gastrointestinal disease. Therefore, appropriate replacement therapy is an essential component of management. Both intravenous (IV) and oral (PO) iron replacement therapies (IRT) are effective. There are concerns, however, that IV therapy is being overutilized. Given higher medication costs, significant time burdens on patients and nursing staff, and reported similar efficacy to PO therapy in select patients, the use of IV therapy should be judicious. Our study reviewed the use of iron replacement therapy amongst gastroenterology inpatients at a tertiary care center. The objectives of our study were to assess the appropriateness of IV iron use, compare patients’ clinical responses to IV and PO therapy, and evaluate predictors of response.

  Methods:
  This study was a retrospective observational chart review. All consecutive patients admitted to the adult gastroenterology inpatient wards between January 1, 2016, to January 1, 2017, who received iron replacement therapy were included. Demographic information was retrieved for all patients. We reviewed patients' iron therapy details, hemoglobin response and clinical outcomes up to 6 months post-discharge.

  Results:
  A total of 202 patients who received IV, oral, or combined IV and oral iron replacement during their admission were included. 56% (n=96/172) of patients in whom IV replacement was prescribed during their admission met the criteria for appropriate use. Overall clinical response was not significantly different between patients receiving IV or PO iron therapy. There were no significant differences between groups in readmission rates within 90 days (p=0.41), emergency department visits within 90 days (p=0.24) and need for blood transfusion within 6 months (p=0.11).

  Conclusion:
  IV IRT is effective but is overused without appropriate indication. PO and IV IRT had similar efficacy. Appropriate usage of IV iron replacement can be optimized through proper rationalization and quality improvement measures.

• Subjects / Keywords

  • Iron Deficiency Anemia
  • Iron replacement Therapy
  • Gastroenterology

• Graduation date

  Spring 2023

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-gezz-eh49

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.