This series of bite-sized episodes contains important information you need to know about iron deficiency and iron deficiency anemia in your female patients. Dr. Malcolm Munro and colleagues discuss recent evidence and provide practical approaches for screening, diagnosing, treating, and preventing the progression of this condition.
Enhancing Adherence with Oral Iron Therapy
Enhancing Adherence with Oral Iron Therapy
Welcome to CME on ReachMD. This episode is part of our MinuteCME curriculum.
Prior to beginning the activity, please be sure to review the faculty and commercial support disclosure statements as well as the learning objectives.
This is CME on ReachMD. We’re here to talk about patient adherence and how we can facilitate that in individuals who are treating with iron deficiency. With me here is Dr. Wendy Wright. Wendy, what can you tell us?
Well, thank you so much, Dr. Munro, and I’m Wendy Wright. I am an adult and family nurse practitioner and the owner of a nurse practitioner-owned and ‑operated primary care clinic. I’m located in Amhurst, New Hampshire. So thank you so much for having me here.
One of the things I’d like to talk a little bit about is patient adherence with oral iron therapies. We know that oral iron therapies historically are associated with a significant number of adverse events.
The reality is that about 50% of patients who take these products have some type of GI [gastrointestinal] intolerance to them, making it often difficult to adhere with the regimen. We also recommend that they take their iron on an empty stomach. We recommend they take it first thing in the morning with a little bit of vitamin C, orange juice – that really does enhance the absorption. But for a lot of people, again, that’s a really tough regimen. So communicating with our patients and educating them about the best ways to take it, about the most common side effects that we’re going to see and why it’s important to take it. I think by also scheduling follow-up appointments and making sure that we’re rechecking their laboratory markers such as their CBCs, as well as their ferritin, is really important in conveying to these patients that this is important and worthy of treating.
What some providers may not realize is that there are a number of studies out there that show that every-other-day iron dosing, such as taking it on a Monday, Wednesday, and Friday, can lead to the same if not better iron absorption than taking it 2 and even 3 times a day, so we should really be adopting that regimen for our patients. And before we send these folks who are unable to tolerate iron off to get IV administration or IV iron, there is a prescription version of iron called ferric maltol. It’s 30 mg, and it’s dosed twice a day, that appears to have less GI side effects, and in the clinical trials looks to be someplace around maybe 5% of patients had a GI side effect.
Yes, and I think our listeners, if they’ve been following along, will realize that hepcidin, which is what does help to control absorption of iron, is elevated with daily dosing of a lot of these ferrous sulfate, ferrous gluconate, but it appears not to be so elevated with ferric maltol.
I think there’s a lot of strategies that we can employ to make sure that our patients are taking their iron. For many people, if we work with them and communicate, we can get them onto oral regimens before we need to then refer for IV therapy. And it’s also important, at least for me in rural America, to recognize that not everyone has access to IV therapies, that they would have to go to an infusion center, and many patients don’t always have ready access to that. So lots of things we can do to improve adherence to their treatments.
Absolutely. Well, there’s a lot of information there. Thank you so much. That’s all the time we have today. Thanks for listening.
You have been listening to CME on ReachMD. This activity is provided by Omnia Education and is part of our MinuteCME curriculum.
To receive your free CME credit, or to download this activity, go to ReachMD.com/Omnia . Thank you for listening.
In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative (GLC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company. GLC mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs.
Malcolm G. Munro MD, FRCS(c), FACOG
Clinical Professor, Department of Obstetrics & Gynecology
David Geffen School of Medicine at UCLA
Chair, Women’s Health Research Collaborative
Los Angeles, CA
Research: AbbVie, Pharmacosmos
Ownership Interest: Channel Medical, Okon, Gynesonics, U-Vision 360
Patent Holder: Simulators – Assigned to AAGL
Consulting Fees: AbbVie, American Regent
Michael Auerbach, MD
Clinical Professor of Medicine
Georgetown University School of Medicine
Research: Covis Pharma
Arjeme Denise Cavens, MD
Instructor of Obstetrics and Gynecology
Northwestern University Feinberg School of Medicine
No relevant relationships reported.
Michael K. Georgieff, MD
Martin Lenz Harrison Land Grant Chair in Pediatrics
Professor of Pediatrics, Obstetrics and Gynecology, and Developmental Psychology
University of Minnesota Medical School
No relevant relationships reported.
Lee P. Shulman, MD, FACOG, FACMG
The Anna Ross Lapham Professor and Chief
Division of Clinical Genetics
Feinberg School of Medicine of Northwestern University
Consulting Fees: Agile, Aspira, Bayer, Biogix, Celula China, Daiichi Sankyo, Mayne, Organon, Shield
Other: Astellas (DSMB Chair)
Wendy L. Wright, DNP, ANP-BC, FNP-BC, FAANP, FAAN, FNAP
Owner and Family Nurse Practitioner
Wright & Associates Family Healthcare
Consulting Fees: AbbVie, Biohaven, GSK, Idorsia, Merck, Moderna, Pfizer, Sanofi, Seqirus, Shield Therapeutics
- Jennifer Brutsche, RN, BSN, AHA BLS Instructor, has nothing to disclose.
- Cindy Davidson has nothing to disclose.
- Libby Lurwick has nothing to disclose.
- Kate Nagele has nothing to disclose.
- Robert Schneider, MSW, has nothing to disclose.
After participating in this educational activity, participants should be better able to:
- Describe the basics of iron physiology, including its critical role in cellular processes, and impact on growth and development throughout the life span.
- Identify appropriate screening and diagnosis methods throughout the life span.
- Describe the potential impact of iron deficiency (ID)/ ID anemia (IDA) and its treatment, throughout the life span.
- Identify the benefits and disadvantages of using oral iron therapies in the management of iron deficiency (ID) and ID anemia (IDA).
This activity is designed to meet the educational needs of obstetrician-gynecologists, other women’s health HCPs, and primary care physicians.
In support of improving patient care, Global Learning Collaborative (GLC) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
Global Learning Collaborative (GLC) designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Global Learning Collaborative (GLC) designates this activity for 1.0 nursing contact hour. Nurses should claim only the credit commensurate with the extent of their participation in the activity.
Global Learning Collaborative (GLC) has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until March 31, 2024. PAs should claim only the credit commensurate with the extent of their participation in the activity.
Omnia Education is the leading provider of education for women’s health professionals. Our activities are recognized nationwide for providing credible, relevant, and practical information on issues impacting the female patient. Additionally, our unique focus has transformed the CME learning environment, and our ability to help learners recognize and overcome barriers to optimal performance and optimal patient outcomes has positioned us as a leader in women’s health education.
This activity is supported by an independent educational grant from Shield Therapeutics.
The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of GLC and Omnia Education. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience, and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients’ conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to link to a site outside of Omnia Education you are subject to the terms and conditions of use, including copyright and licensing restriction, of that site.
Reproduction of this material is not permitted without written permission from the copyright owner.
Our site requires a computer, tablet, or mobile device and a connection to the Internet. For best results, a high-speed Internet connection is recommended (DSL/Cable/Fibre). We also recommend using the latest version of your favorite browser to ensure compliance with W3C standards, such as Chrome, Safari, Firefox, or Microsoft Edge.