Anemia Management Today: Blood Conservation, Transfusion, & New Options CME/CE

Amir Jaffer, MD; L. Tim Goodnough, MD; Lena Napolitano, MD; Ajay Kumar, MD

Release Date: August 3, 2007; Valid for credit through August 3, 2008
Target Audience

This activity was developed for hospitalists and physicians who attend to oncology, surgical, and chronic kidney disease patients. It is appropriate for pharmacists who practice in general hospital settings, critical care settings, or oncology settings, as well as pharmacists with an interest in anemia and chronic kidney disease.

Goal

Better use of blood products and hospital resources, and improved patient outcomes can be achieved by adopting anemia management and blood management strategies that include principles of bloodless medicine and the systematic use of blood conservation techniques in all patients.

The clinical consequences of untreated anemia have been well documented. A study found both anemia and chronic kidney disease highly prevalent among heart failure patients and independently associated with an increased risk of hospital mortality of being readmitted within 30 days. Cancer-related anemia has been linked with reduced survival, reduced therapy efficacy, and diminished quality of life. Preoperative anemia was associated with an increased incidence of postoperative infections and longer hospital stays in 225 elective total hip replacement patients. Anemia increases the cost of delivering health care by over 50%.

Although transfusion has been considered the mainstay treatment for anemia, it is now known to be associated with increased complications, increased mortality and poorer outcome, and longer length of stay. The direct and indirect costs of one unit of whole blood have more than tripled (from $150 to $500/unit). It is estimated that hospitals could spend up to an additional $3 million per year on blood, which could lead to other cutbacks within a facility.

Learning Objectives

Upon completion of this activity, participants should be able to:

• Describe the prevalence, incidence, etiology, and impact anemia has on the surgical, oncologic, and chronic kidney disease patient populations.
• Identify blood conservation strategies and disease-specific algorithms for anemia management that correlate with early detection, assessment, intervention, response of treatment, follow up, and improved patient outcomes.
• Summarize data supporting the early impact of erythropoietic agents on clinical outcomes, economic performance, and improved use of blood/blood components.
• Explain how to set up a blood management program to reduce the use of blood and blood components.
• Discuss the implementation of blood conservation strategies on a hospital-wide level and consequent benefits.

Contents of This CME/CE Activity

1. 1. Introduction Amir Jaffer, MD Available As: Slides/Audio | Slides/Transcript | Audio
   2. Outcomes of Anemia Treatment Options in Oncology & CKDL. Tim Goodnough, MD Available As: Slides/Audio | Slides/Transcript | Audio
   3. Anemia and Transfusion: The Impact on Surgical Outcomes Lena Napolitano, MD Available As: Slides/Audio | Slides/Transcript | Audio
   4. Blood Conservation Protocol: A Case Study Ajay Kumar, MD Available As: Slides/Audio | Slides/Transcript | Audio
   5. Question & Answer Session Ajay Kumar, MD; Lena Napolitano, MD; L. Tim Goodnough, MD; Amir Jaffer, MD Available As: Slides/Audio | Slides/Transcript | Audio

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