Scientific Poster Session III - Original Research

Original Research
  Monday, November 13, 2023
  01:00 PM–02:30 PM

Abstract

Introduction: The cost burden of calcitonin, in particular the cost associated with waste generated from conventional weight-based dosing (CWBD), emphasizes the need to optimize calcitonin dosing. Our five-hospital health-system adopted a standardized calcitonin weight rounded dosing scheme (WRDS) where patients receive a 200-, 300- or 400-unit dose limiting the dose to a maximum of one vial size. However, WRDS has led some patients to receive suboptimal doses of calcitonin.

Research Question or Hypothesis: We investigated if WRDS of calcitonin was an effective means to reduce serum calcium despite potentially under-dosing individuals and if there is a cost benefit associated with utilizing WRDS.

Study Design: Multicenter, retrospective chart review

Methods: This study included 160 patients who received calcitonin from July 1^st, 2020, to December 15^th, 2021. Laboratory values were obtained via chart review to determine initial corrected serum calcium (CSC) and a 12-hour CSC post administration of calcitonin. Usage of calcium lowering adjunctive treatments were collected including intravenous fluids and bisphosphonates. Purchasing data was recorded to determine calcitonin vial consumption. Data analysis was performed using R software and analyzed using two sample T-Test to assess for any statistically significant differences.

Results: Assessment of calcitonin administration utilizing WRDS showed no difference in average number of calcitonin doses administered during hospital stay compared to CWBD (3.02 vs 3.61, P= 0.86). The 12-hour CSC was similar when comparing WRDS to the CWBD (1.78 g/dL vs 1.72 g/dL, P = 0.62). During this time the health system purchased 74 less vials while utilizing WRDS resulting in >$100,000.00 waste reduction.

Conclusion: Weight based dose rounding scheme is an effective method of reducing CSC as compared to CWBD. Patient using WRDS did not seem to need additional doses of calcitonin to achieve a therapeutic response. These findings suggest that utilizing WRDS when administering calcitonin is clinically effective and cost-effective.

Presenting Author

Mohammed Rabah PharmD
Yale New Haven Health System

Authors

Charles Jones PharmD, BCPS
Yale New Haven Health

Phu Huynh PharmD, BCPS
Yale New Haven Health