Reardon Gregory, Wasserman Michael R, McKenzie R Scott, Hord R Steve, Kilpatrick Brett, Bailey Robert A
Informagenics, LLC, Columbus, OH, USA.
Consult Pharm. 2012 Sep;27(9):627-40. doi: 10.4140/TCP.n.2012.627.
To evaluate the prevalence of chronic kidney disease (CKD) and anemia in the long-term care facility, the rate of recognition of these conditions, and the specific interventions used to treat anemia.
Retrospective cross-sectional analysis.
Twenty-seven long-term care facilities in Colorado.
PATIENTS, PARTICIPANTS: Had > 90-day residency in the long-term care facility; had index serum creatinine and hemoglobin (Hb) values ± 90 days of the earliest (index) Minimum Data Set (MDS). Data were derived from the AnalytiCare(sm) database (January 1, 2007-September 15, 2008) containing laboratory results, MDS reports, and pharmacy fills. Residents with laboratory-defined CKD had estimated glomerular filtration rates < 60 mL/min/1.73 m(2). Those with laboratory-defined anemia had < 12 g/dL Hb females, < 13 g/dL Hb males. MDS reports indicated recognition of CKD and anemia. Prescription records identified anemia-related pharmacotherapy for anemic residents.
Prevalence rates of laboratory-defined CKD and anemia, recognition rates of anemia and CKD, and rates of use of specific anemia pharmacotherapies.
For 838 eligible residents, laboratory findings showed a prevalence rate of 43% for CKD and 46% for anemia. Only 2.8% and 14.6% of residents with laboratory defined CKD had CKD recognized on the index, or any index or postindex MDS, respectively. Anemia recognition rates were 9.6% and 39.9%, respectively. No single anemia prescription therapy class (erythropoiesis stimulating agents, iron, vitamin B(12), or folic acid) was used for more than 10% of all residents with laboratory- or MDS-defined anemia.
For CKD and anemia, the lack of concordance between laboratory- and MDS-identified disease should alert health care professionals of potential under-recognition within the long-term care facility.
评估长期护理机构中慢性肾脏病（CKD）和贫血的患病率、对这些病症的识别率以及用于治疗贫血的具体干预措施。
回顾性横断面分析。
科罗拉多州的27家长期护理机构。
患者、参与者：在长期护理机构居住超过90天；有最早（索引）最小数据集（MDS）±90天内的血清肌酐和血红蛋白（Hb）指标值。数据来自AnalytiCare(sm)数据库（2007年1月1日至2008年9月15日），包含实验室检查结果、MDS报告和药房配药记录。实验室确诊的CKD患者估计肾小球滤过率<60 mL/min/1.73 m²。实验室确诊的贫血患者，女性Hb<12 g/dL，男性Hb<13 g/dL。MDS报告显示对CKD和贫血的识别情况。处方记录确定贫血居民的贫血相关药物治疗情况。
实验室确诊的CKD和贫血的患病率、贫血和CKD的识别率以及特定贫血药物治疗的使用率。
对于838名符合条件的居民，实验室检查结果显示CKD患病率为43%，贫血患病率为46%。实验室确诊的CKD居民中，分别只有2.8%和14.6%在索引、任何索引或索引后MDS中被识别出患有CKD。贫血识别率分别为9.6%和39.9%。在所有实验室或MDS确诊贫血的居民中，没有一种贫血处方治疗类别（促红细胞生成素、铁、维生素B12或叶酸）的使用比例超过10%。
对于CKD和贫血，实验室和MDS识别的疾病之间缺乏一致性，这应提醒医疗保健专业人员注意长期护理机构中可能存在的识别不足问题。
