Presenting Authors: Sonia Talwar, PharmD, Pharmacosmos Therapeutics, Morristown, NJ; Les Louden, PharmD, MS, St Joseph’s Hospital-BayCare Health System, Tampa, FL
Co-Authors: Barbara J. Wilson, MS, RN, AOCN, ACNS-BC, Self-Employed, Marietta, GA; Eun-Ju Lee, MD, Weill Cornell Medicine, New York, NY
BACKGROUND: Iron deficiency anemia (IDA) affects approximately 5 million people in the United States and has a substantial effect on health and quality of life (QoL). Intravenous iron (IVI) is indicated for the treatment of IDA when oral iron is not effective or tolerated. Although IVI treatments are effective, some patients miss or delay their appointments, potentially leading to incomplete IVI treatment response.
OBJECTIVE: To identify the barriers to treatment with IVI from the patient perspective.
METHODS: In early 2023, patients aged >18 years in the United States with a confirmed diagnosis of IDA who recently received IVI therapy were asked to respond to an online survey conducted by The Harris Poll. The questions queried patient demographics, appointment logistics, IVI infusion experience, the impact of infusion on daily activities, the reason(s) for missed doses, and ways to improve adherence.
RESULTS: A total of 323 patients completed the survey, of whom 193 reported being prescribed ≥2 IVI infusions per month; 71 of the 193 (36.8%) patients reported having missed at least 1 dose. These 71 patients had an average age of 34.9 years and were mostly female (76.1%) and Caucasian (64.8%). The patients resided in urban areas (45.1%), near a city (38.0%), or in rural areas (16.9%). The leading causes of IDA were heavy menstrual bleeding (36.6%) and inflammatory bowel disease (18.3%). Respondents received an average of 2.62 IVI infusions monthly. The average reported time (minutes) spent on IVI appointment logistics included scheduling the infusions (46), traveling to the infusion center (76), the arrival to the start time of the infusion (51), and infusion chair time (89). Patients reported that IVI treatment negatively impacted their productivity (63.4%) and their attendance at important events (64.8%), and they schedule their life around treatment (80.3%). The most common reasons for missing a dose were “due to a conflict,” “fitting the scheduled appointment,” and “transportation difficulties.” Most patients (84.5%) agreed that fewer IVI infusions would improve adherence to the full prescribed course of therapy. Overall, 38% of patients were not satisfied with the infusion frequency, 84.5% preferred fewer trips, and 85.9% would favor a single-dose option.
CONCLUSION: Despite the therapeutic benefits of IVI treatment, more than one-third of patients prescribed ≥2 IVI infusions monthly reported missing an infusion. The time spent on arranging and receiving IVI treatment negatively impacted patients’ perspectives on their treatment. From these variables, the patients’ preference for a single-dose treatment option may improve adherence and QoL. Based on the responses, convenience should be included and discussed when determining an IVI treatment choice, because it plays an important role in patient adherence.
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