Analyse des processus de gestion des agents stimulant l’érythropoïèse et du fer intraveineux dans 12 établissements de dialyse en France : étude TERRA

Introduction We explored the organizational and environmental impacts of the management of erythropoiesis-stimulating agents (ESAs) and intravenous iron for the treatment of chronic kidney disease-related anemia in France.Methods An electronic survey (March-November 2023) was completed by the head of the supplying pharmacy from 12 dialysis organizations. Eligible organizations reserved ESAs or could identify the ESA prescriptions for dialysis-dependent patients. Primary endpoints were time spent on ESA management and frequency of tasks. Secondary endpoints included the environmental impact of ESAs and the organizational impacts of IV iron management.Results ESA management required 313.9 h/month per dialysis organization, of which 285.3 h were spent on injection, preparation, administration, and post-administration monitoring. Three-quarters (74.2%) of cold storage space was dedicated to ESAs. IV iron management required 779.3 h/month per dialysis organization, of which 664 h were attributable to administration and post-infusion monitoring.Conclusion Management of ESAs and IV iron required substantial time and resources in French dialysis organizations.