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[Hemorrhage treatment: Evaluation of the proper use of fibrinogen concentrate]

Jennifer Howlett1, Christelle Prudent1, Emmanuel De Maistre2

  • 1Service pharmacie, hôpital François-Mitterrand, 14, rue Gaffarel, 21000 Dijon, France.

Therapie
|March 25, 2017
PubMed

Insights

Fibrinogen concentrate prescriptions increased after 2015 guidelines. Evaluation showed appropriate dosing in 73% of cases, but low fibrinogen levels were below recommended limits in 59%, questioning prescription necessity.

Area of Science:

  • Hematology
  • Clinical Pharmacy
  • Medical Guidelines

Background:

  • Fibrinogen concentrate prescriptions rose significantly in 2015 following new guideline publications.
  • The study addresses the need to assess the appropriate utilization of fibrinogen concentrate post-guideline implementation.

Purpose of the Study:

  • To evaluate the conformity of fibrinogen concentrate prescriptions with established clinical guidelines.
  • To assess the appropriateness of prescribed dosages and patient outcomes.

Main Methods:

  • Retrospective analysis of 202 prescriptions for 117 patients.
  • Evaluation criteria included fibrinogen level measurement, adherence to recommended dosage thresholds, and posology conformity.
  • Assessment of treatment efficacy and safety was also performed.

Main Results:

  • Indications for prescription were met in all but one case.
  • Blood fibrinogen levels were measured in 76% of prescriptions, with 59% below the recommended threshold for prescription.
  • Prescription posology aligned with guidelines in 73% of cases; 20% were underdosed.
  • Patients receiving lower doses appeared to have lower risk, raising questions about prescription necessity.

Conclusions:

  • Guideline adherence for fibrinogen concentrate prescription varies, influenced by the urgency of the clinical situation.
  • Further prospective studies are recommended to elucidate the reasons for prescribing doses below guideline recommendations.

Keywords:
FibrinogenFibrinogèneHemorrhageHémorragiePrescription

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