Postal questionnaire to examine poor compliance with anaemia therapy as a poor response to ESA
A Roche, I Macdougall
Problem: A suggestion of poor compliance with anaemia treatment is an obvious and yet under-investigated cause of a poor response to erythropoiesis stimulating agents (ESA).
Purpose: To examine whether poor compliance is a significant problem, and if so, to determine the barriers to concordance with ESA therapy within the local renal population.
Design: An anonymous postal survey (with return SAE) was distributed to all patients currently receiving ESA treatment (n=592). Aspects addressed within the survey included knowledge of drug, storage, who administers EPO and how often, patient preferences, missed injections and the reasons for this.
Findings: A response rate of 69% was achieved (410 replies). Most patients were aware of which drug (brand) they were prescribed and how often it should be injected. There were a number of different care providers responsible for administering the injections to patients including self-administration (n=260), family members/carers (n=34), GP (n=3), Practice Nurse (n=18), District Nurse (n=24) and Dialysis Nurse (n=71). 25% of respondents miss injections to varying degrees, from occasional missed injections to frequently missed injections. The main reasons listed were: poor continuity of supply, injection discomfort, their nurse does not administer, patient forgets injection.
Conclusions: The findings of this survey highlight the need to discuss these issues regularly with patients when their treatment and progress is being reviewed to ensure flexible options and choice are provided.
Relevance: The outcomes of this survey highlight priority areas for improvement within the clinical anaemia programme, namely to facilitate continuity of drug supply and the provision and review of flexible treatment options.