SHM Converge Scientific Abstract ePoster Gallery-From Daily to Durable: Improving Post-Hospitalization Iron Therapy Compliance Through Evidence-Based Dosing Redesign

From Daily to Durable: Improving Post-Hospitalization Iron Therapy Compliance Through Evidence-Based Dosing Redesign

Pdf Summary

This quality improvement project evaluated whether changing post-discharge ferrous sulfate from daily to every-other-day dosing would improve adherence in patients with iron deficiency anemia (IDA). The rationale was based on iron physiology: consecutive daily dosing increases hepcidin, which can reduce intestinal iron absorption and may worsen gastrointestinal side effects, a major reason patients stop therapy.<br /><br />At baseline, the team reviewed 60 hospitalized patients with IDA who were prescribed ferrous sulfate after discharge. Among the 42 patients on daily dosing, adherence was only 45%, with GI intolerance identified as the main barrier. The intervention switched patients from daily to alternate-day ferrous sulfate and included brief education about improved tolerability and hepcidin-guided absorption.<br /><br />Six months after implementation, adherence improved substantially to 83%. In the subgroup with follow-up laboratory data (13 patients), hemoglobin and iron indices remained stable, suggesting that the alternate-day strategy preserved efficacy while improving tolerability. No decline in hematologic parameters was observed during follow-up.<br /><br />The project concluded that a simple, low-cost prescribing change—aligning iron dosing with hepcidin physiology—can meaningfully improve post-hospitalization adherence in IDA without compromising iron repletion. This supports alternate-day oral iron as a scalable approach for hospital medicine to reduce side effects and improve long-term treatment success.

Asset Subtitle

Gauri Pikale

Meta Tag

Author List Aditya Suresh, Erin Davis-Delay, Gauri Pikale, Harin Shah, Joaquim Noguer, Nasibul Alam

Category Innovations

Concept Ferrous Sulfate

Concept Alternate-Day Dosing

Concept Iron Deficiency Anemia

Concept Iron Absorption

Concept Tolerability

Distinguished Non-Finalist

Presenter Organization Northwestern Medicine McHenry Hospital/Rosalind Franklin University of Medicine and Science

Presenting Author Gauri Pikale

Track Transitions of Care

Keywords

iron deficiency anemia

ferrous sulfate

alternate-day dosing

adherence

hepcidin

gastrointestinal intolerance

post-discharge

oral iron therapy

hemoglobin

quality improvement

Ferrous Sulfate

Alternate-Day Dosing

Iron Deficiency Anemia

Iron Absorption

Tolerability