Epoetin and Darbepoetin Reduce Need for Transfusions, Increase Risk of Blood Clots for Anemia in Cancer Patients, Review Finds

Electronic Newsletter, Issue 378

AHRQ's Electronic Newsletter summarizes Agency research and programmatic activities.

April 29, 2013

AHRQ Stats

Nearly 59 million U.S. adults age 18 and older were treated for high blood pressure in 2010. That total included 62 percent of seniors age 65 and older, 32 percent of adults age 45 to 64, and 6 percent of people age 18 to 44. (Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Statistical Brief #404, Expenditures for Hypertension among Adults Age 18 and Older, 2010: Estimates for the U.S. Civilian Noninstitutionalized Population.)

Today's Headlines

  1. Epoetin and Darbepoetin Reduce Need for Transfusions, Increase Risk of Blood Clots for Anemia in Cancer Patients, Review Finds.
  2. AHRQ's Health Care Innovations Exchange Highlights Patient-Reported Data to Improve Chronic Disease Care.
  3. Nominations Sought by May 3 for AHRQ Quality Indicators Workgroups.
  4. AHRQ's April Issue of Web M&M Examines Factors Leading to Error in Total Parenteral Nutrition .
  5. New AHRQ Research Review Evaluates Behavioral Interventions to Improve Cardiovascular Disease Risk Factors in Patients with Serious Mental Illness.
  6. New Review of Pulmonary Arterial Hypertension Screening, Management, and Treatment Finds More Research Needed.
  7. Register Now for AHRQ's MEPS Data Users' Workshop on May 8-9.
  8. AHRQ in the professional literature.

 1. Epoetin and Darbepoetin Reduce Need for Transfusions, Increase Risk of Blood Clots for Anemia in Cancer Patients, Review Finds

Epoetin and darbepoetin reduce the need for blood transfusions in cancer patients with anemia receiving chemotherapy and/or radiotherapy treatment, according to an updated research review from AHRQ. These findings are consistent with a previous review on this topic published in 2006. However, epoetin and darbepoetin are associated with an increased risk of thromboembolism, and the use of these therapies increases the risk of death during and shortly following treatment, the review found. Insufficient evidence exists to draw conclusions about the long-term effects of these treatments on survival. These findings are available in the research review, Epoetin and Darbepoetin for Managing Anemia in Patients Undergoing Cancer Treatment—Comparative Effectiveness Update.

 2. AHRQ's Health Care Innovations Exchange Highlights Patient-Reported Data to Improve Chronic Disease Care

The latest issue of AHRQ's Health Care Innovations Exchange features programs that use patient-reported data to help manage chronic disease care and reduce costs. One of the featured profiles describes an assessment tool that patients with diabetes can use to identify and address their biggest quality of life concerns. Prior to a visit with a clinician, patients identify their greatest concerns and complete a checklist that defines specific aspects of those concerns. Patients then rate their general sense of well-being. Based on the input, the tool generates a list of potential interventions, including treatment modifications and referrals. The tool enhances communication between providers and patients, facilitates discussions about patients' greatest concerns, and generates an electronic display that depicts trends in patients' responses over time. Feedback about the tool from both patients and clinicians has been positive. View more innovation profiles related to the use of technology and patient-reporting to improve chronic disease care on the Innovations Exchange Web site, which contains more than 775 searchable innovations and 1,525 Quality Tools.

 3. Nominations Sought by May 3 for AHRQ Quality Indicators Workgroups

AHRQ is seeking nominations by May 3 for individuals with knowledge of AHRQ's Quality Indicator™, their technical specifications, and associated methodological issues to serve on two workgroups. The goal of each group is to provide feedback to AHRQ on making refinements to the QIs. Individuals can be nominated to either a time-limited workgroup or a standing workgroup, both of which will be convened by an AHRQ contractor. The time-limited workgroup will focus on specific clinical or methodological issues, while the standing workgroup will address broader issues related to the measurement cycle. AHRQ did not receive a sufficient response to a Federal Register notice published on January 28 (Volume 78, No. 18, page numbers: 5810 and 5811) seeking candidates to serve on these workgroups; therefore, it is re-submitting this notice. Select to access the Federal Register notice. Self-nominations are welcome and should specify the workgroup of interest. Candidates may apply for both workgroups. Third-party nominations must indicate that the individual has been contacted and is willing to serve on the workgroup. AHRQ will contact selected candidates by May 17. For more information, contact Pam Owens at 301-427-1412 or Pam.Owens@ahrq.hhs.gov.

 4. AHRQ's April Issue of Web M&M Examines Factors Leading to Error in Total Parenteral Nutrition

The April issue of AHRQ Web M&M features a Spotlight Case describing how a 3-year-old boy hospitalized with anemia who was receiving chronic total parenteral nutrition (TPN) was given a 10-fold increase in the amount of sodium in the TPN. The error was recognized, corrected, and the boy did not experience any adverse consequences. Upon a formal review of the case, multiple errors led to the excess sodium error, including inaccurate transcription by the pharmacist into the hospital's computerized provider order entry system and multiple automatic warning systems that were ignored. A commentary on the case is provided by Joseph I. Boullata, Pharm.D., R.Ph., professor of pharmacology and therapeutics at the University of Pennsylvania, Philadelphia. The Perspectives on Safety feature section features an interview with Christopher Landrigan, M.D., associate professor of medicine and pediatrics at Harvard Medical School, Boston, whose research on the effects of sleep deprivation has led to policy changes in resident duty hours and supervision. Physicians and nurses can receive free CME, CEU, or training certification by taking the Spotlight Quiz. Select to read the current issue of AHRQ Web M&M.

 5. New AHRQ Research Review Evaluates Behavioral Interventions to Improve Cardiovascular Disease Risk Factors in Patients with Serious Mental Illness

A new research review from AHRQ evaluates interventions to improve cardiovascular disease (CVD) risk factors in patients with serious mental illness. Individuals with serious mental illness have excess mortality from CVD and high rates of risk factors such as diabetes, obesity, and hyperlipidemia. The review finds moderate strength of evidence that behavioral interventions are associated with small decreases in weight. No interventions were found to be effective for glucose control and hyperlipidemia in this patient population. These findings can be found in the research review, Interventions to Improve Cardiovascular Risk Factors in People With Serious Mental Illness.

 6. New Review of Pulmonary Arterial Hypertension Screening, Management, and Treatment Finds More Research Needed

More research is needed to determine the comparative validity, reliability, and feasibility of various screening, diagnostic, management, and treatment strategies for pulmonary arterial hypertension (PAH), according to a new AHRQ research review. This disease is rare and progressive, and, left untreated, can lead to heart failure and premature death. Specifically, the review finds that additional research is needed to determine if the combination of echocardiography and the biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP)—two investigational diagnostic strategies for PAH – is sufficiently accurate to rule out the disease when testing patients with symptoms. More research is also needed to determine their effectiveness for screening asymptomatic patients who are at risk for PAH. Among patients with PAH, the biomarkers B-type natriuretic peptide (BNP) and uric acid, as well as the size of the right atrium of the heart and the presence of pericardial effusion (fluid around the heart) correlate with disease prognosis. Although the studies reviewed were not designed to detect a mortality reduction from treatment, all drug classes and combination therapy regimens improve the distance covered during the standard 6-minute walk test and reduce hospitalization rates when compared with placebo. However, comparisons between specific treatment regimens remain inconclusive. These findings are available in the research review, Pulmonary Arterial Hypertension: Screening, Management, and Treatment.

 7. Register Now for AHRQ's MEPS Data Users' Workshop on May 8-9

Registration is now open for a hands-on AHRQ Medical Expenditure Panel Survey Data Users' Workshop in Rockville, MD, on May 8-9. The workshop is designed for health services researchers who have a background or interest in using national health surveys. Select for more information and to register for the workshop.

 8. AHRQ in the Professional Literature

Liu V, Turk BJ, Rizk NW, et al. The association between sepsis and potential medical injury among hospitalized patients. Chest 2012 Sep; 142(3):606-13. Select to access the abstract on PubMed®.

Desai R, Curns AT, Steiner CA, et al. All-cause gastroenteritis and rotavirus-coded hospitalizations among US children, 2000-2009. Clin Infect Dis 2012 Aug; 55(4):e28-e34. Select to access the abstract on PubMed®.

Brokel JM, Ward MM, Wakefield DS, et al. Changing patient care orders from paper to computerized provider order entry-based process. Comput Inform Nurs 2012 Aug; 30(8):417-25. Select to access the abstract on PubMed®.

Curtis JR, Safford MM. Management of osteoporosis among the elderly with other chronic medical conditions. Drugs Aging 2012 Jul; 29(7):549-64. Select to access the abstract on PubMed®.

Jacob MG, Wachs JP, Packer RA. Hand-gesture-based sterile interface for the operating room using contextual cues for the navigation of radiological images. J Am Med Inform Assoc 2012 Dec 18. Select to access the abstract on PubMed®.

Karve S, Candrilli S, Kappelman MD, et al. Healthcare utilization and comorbidity burden among children and young adults in the United States with systemic lupus erythematosus or inflammatory bowel disease. J Pediatr 2012 Oct; 161(4):662-70.e2. Select to access the abstract on PubMed®.

Hubert KC, Kokorowski PJ, Huang L, et al. Clinical outcomes and long-term resolution in patients with persistent vesicoureteral reflux after open ureteral reimplantation. J Urol 2012 Oct; 188(4 Suppl):1474-9. Select to access the abstract on PubMed®.

Thomas KS, Dosa D, Hyer K, et al. Effect of forced transitions on the most functionally impaired nursing home residents. J Am Geriatr Soc 2012 Oct; 69(10):1895-900. Select to access the abstract on PubMed®.

Contact Information

Please address comments and questions regarding the AHRQ Electronic Newsletter to Linwood Norman at Linwood.Norman@ahrq.hhs.gov or (301) 427-1248.

Update your subscriptions, modify your password or Email address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your Email address to log in.

If you have any questions or problems with the subscription service, Email: updates@subscriptions.ahrq.gov. For other inquiries, Contact Us.

This service is provided to you at no charge by the Agency for Healthcare Research and Quality AHRQ).

Page last reviewed April 2013
Internet Citation: Epoetin and Darbepoetin Reduce Need for Transfusions, Increase Risk of Blood Clots for Anemia in Cancer Patients, Review Finds: Electronic Newsletter, Issue 378. April 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/newsletters/e-newsletter/378.html