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Table 2 Trends by quarter within 2011 in medication use and laboratory values by dialysis facility 25% and 100% opt-in status

From: Comparative changes in treatment practices and clinical outcomes following implementation of a prospective payment system: the STEPPS study

 

25% facilities (N = 11)

100% facilities (N = 38)

N (%), Mean ± SD

Q1 2011 (n = 346)

Q2 2011 (n = 325)

Q3 2011 (n = 311)

Q4 2011 (n = 298)

p-trend

Q1 2011 (n = 1266)

Q2 2011 (n = 1236)

Q3 2011 (n = 1166)

Q4 2011 (n = 1125)

p-trend

ESA administration a

          

EPO monthly dose (units)

67624 ± 64409

62226 ± 64937

59134 ± 64567

54814 ± 57216

<0.0001

46294 ± 48614

46071 ± 47388

37973 ± 41916

40892 ± 43618

<0.0001

IV EPO monthly dose (units)

68687 ± 64337

63694 ± 65008

58813 ± 64117

55029 ± 56670

<0.0001

45455 ± 47892

45503 ± 46503

37300 ± 41087

42225 ± 45218

<0.0001

SC EPO monthly dose (units)

54904 ± 65232

46254 ± 63186

62404 ± 70244

52500 ± 64087

0.89

53561 ± 54168

51289 ± 54835

43056 ± 47596

33294 ± 32131

0.59

SC (vs.IV) ESA routeb

25 (7.7)

26 (8.4)

26 (8.9)

24 (8.5)

0.22

112 (9.6)

105 (9.1)

122 (11.4)

152 (14.8)

<0.0001

Other medications c

          

Cinacalcet use

97 (28.0)

92 (28.3)

85 (27.3)

81 (27.2)

0.43

336 (26.5)

370 (29.9)

359 (30.8)

356 (31.6)

<0.0001

Phosphate binder use

237 (68.5)

226 (69.5)

229 (73.6)

214 (71.8)

0.85

849 (67.1)

883 (71.4)

872 (74.8)

827 (73.5)

<0.0001

Iron use

251 (72.5)

221 (68.0)

216 (69.5)

223 (74.8)

0.9

903 (71.3)

917 (74.2)

817 (70.1)

752 (66.8)

0.004

Oral (vs.IV) iron routeb

1 (0.4)

1 (0.5)

2 (0.9)

3 (1.3)

-

8 (0.9)

13 (1.4)

14 (1.7)

13 (1.7)

0.21

Vitamin D use

294 (85.0)

275 (84.6)

254 (81.7)

246 (82.6)

0.20

975 (77.0)

967 (78.2)

927 (79.5)

914 (81.2)

0.001

Oral (vs.IV) vitamin D routeb

11 (3.7)

6 (2.1)

3 (0.2)

4 (2.1)

0.03

151 (15.5)

202 (20.9)

219 (23.6)

226 (24.7)

<0.0001

Laboratory values a

          

Hemoglobin (g/dL)

11.3 ± 1.2

11.3 ± 1.3

11.3 ± 1.3

11.0 ± 1.1

0.0002

11.1 ± 1.3

11.0 ± 1.2

10.9 ± 1.3

10.7 ± 1.2

<0.0001

Hemoglobin <10 g/dL

41 (11.8)

37 (11.4)

41 (13.2)

40 (13.4)

0.34

229 (18.1)

226 (18.3)

251 (21.5)

268 (23.8)

<0.0001

Hemoglobin ≥12 g/dL

96 (27.7)

92 (28.3)

87 (28.0)

52 (17.4)

0.004

314 (24.8)

225 (18.2)

210 (18.0)

132 (11.7)

<0.0001

PTH (pg/dL)

393.4 ± 332.9

500.8 ± 404.4

412.1 ± 330.7

458.7 ± 355.3

0.70

380.2 ± 305.9

399.2 ± 315.4

414.3 ± 321.8

436.3 ± 343.7

<0.0001

Calcium (mg/dL)

8.8 ± 0.8

8.8 ± 0.8

8.9 ± 0.7

8.9 ± 0.7

0.06

8.9 ± 0.6

8.9 ± 0.7

8.9 ± 0.7

8.8 ± 0.7

<0.0001

Phosphorus (mg/dL)

5.2 ± 1.5

5.4 ± 1.7

5.4 ± 1.6

5.2 ± 1.5

0.63

5.2 ± 1.6

5.3 ± 1.6

5.3 ± 1.7

5.2 ± 1.6

0.14

TSAT (%)

30.8 ± 12.9

30.9 ± 12.7

33.0 ± 13.8

30.1 ± 11.4

0.82

32.7 ± 12.5

32.9 ± 12.6

33.5 ± 12.3

31.6 ± 11.7

0.19

Ferritin (ng/mL)

677.7 ± 383.2

663.6 ± 409.8

739.6 ± 405.9

693.8 ± 364.0

0.001

826.8 ± 438.0

849.2 ± 456.3

933.5 ± 471.8

922.6 ± 472.8

<0.0001

  1. aAssessed during last eligible month in each quarter; bLast administered route in each quarter among users; cAny use during the quarter.
  2. EPO, epoetin alfa; IV, intravenous; SC, subcutaneous; ESA, erythropoiesis stimulating agent; TSAT, transferrin saturation; PTH, parathyroid hormone.
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