Moving over to the ASH #ChoosingWisely campaign because this title definitely caught my attention (reducing unnecessary premeds for parenteral iron therapy)! #ASH22 @ASH_hematology props for making this a session. 1/n
@ASH_hematology Introducing Dr. Carol Mathew @CarolMathewMD from University of Florida. Some background, they have an infusion center with 47 chairs (on the onc floor - haha) with 3000+ iron infusions. #ASH22 2/n
@ASH_hematology @CarolMathewMD Why do people think we need to premedicate? mostly from high molecular weight iron which they no longer have since 2009. Fishbane reactions resolve within a few minutes after stopping -- as opposed to anaphylaxis (1 in 250,000 infusions!) #ASH22 3/n 
@CarolMathewMD In fact, premedications might have some effects without clear benefit of giving them. Actually higher rates of hypersensitivity reactions happen in those that are premedicated. #ASH22 4/n
@CarolMathewMD They did a 6 month baseline, did the intervention for 3 months followed by a post intervention analysis. Goal: only Rx for those that are at high risk for infusion reaction. Turns out 80% from the baseline wouldn't have met this criteria. #ASH22 5/n
@CarolMathewMD Here were the interventions done - including highlighting Fishbane reactions and asked providers to document why they did premeds when they Rx'd this and removed it from their order sets. (was giving PO acetaminophen and diphenhydramine before) #ASH22 6/n
@CarolMathewMD Outcome -- not quite the 50% reduction they were hoping for, but getting there. Did see some more mild reactions but it was evenly split between those that receiving premeds and not. Had 12% reduction in overall chair time which leads to cost reduction. #ASH22 7/7
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