January 28, 2002

A Winning Drug Protocol

Dialysis Center Receives National Attention

What do you do with a successful drug protocol that helps dialysis patients win back precious energy while also reducing costs 40 percent per treatment?

Spread the good results and earn recognition from pharmacists across North America. That's just what staff pharmacist Norm Nichols did with the results of a successful drug protocol underway at Genesis Medical Center's Edwin A. Motto Dialysis Center. Recently, he had the honor of making a poster presentation at a worldwide meeting of the American Society of Health System Pharmacists in New Orleans.

National Recognition
The presentation focused on the center at Genesis' use of the drug Epogen, a drug taken by dialysis patients to stimulate their body into producing more red blood cells. During dialysis, a machine removes the waste products from the blood of patients whose kidneys no longer function. This process takes four or five hours, three times a week, and causes them to be anemic. To make them less anemic, Epogen boosts patients' red blood cell count, or hematocrit levels.

With the support of John Placko, Manager of Pharmacy, the drug protocol was developed by Nichols; Michele Root, Clinical Nurse Specialist for Dialysis; and Dr. Edwin V. Motto, whose father was the founder of the Dialysis Unit at Genesis. The unit is the only hospital-based center in the Quad Cities.

Under the protocol, patients' hematocrit levels are closely monitored to determine the best Epogen dosage to bring them into the optimal 33-36 percent hematocrit range. The protocol has been underway for two years.

"Twenty-two pharmacists from all over the U.S. and Canada requested copies of our protocol and results so they could report back to their respective hospitals," Nichols says. "Epogen is one of the most expensive drugs on the budget. They wanted to develop a protocol similar to ours to help control costs."

Patients Feel Better
Under the protocol, dose adjustments are made based on the levels of hematocrit and hemoglobin in the patients' blood. "By testing patients every month and adjusting doses, we can reduce costs and more importantly, help patients to feel better and stay out of the hospital," Nichols says. "We were spending an average $50 per patient per treatment. We've reduced that to $30 per patient per treatment and improved patients' energy levels as well."

The result is a $370,000 cost-savings per year and a better quality of life for the center's 130 dialysis patients. Genesis, which has the largest dialysis center in the state, also has the distinction of being the only center in Iowa to have a registered pharmacist (Nichols) and a nurse (Root) working together as team on the very labor-intensive protocol. "Usually, there are no pharmacists in the dialysis unit," Nichols says.