Blood transfusion practice in the UK and Ireland: a survey of palliative care physicians
Autor: | Simon J. Stanworth, Karen Neoh, Michael I. Bennett |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty Blood transfusion Palliative care Attitude of Health Personnel media_common.quotation_subject medicine.medical_treatment education Medicine (miscellaneous) Nice Nice guidance 03 medical and health sciences Sex Factors 0302 clinical medicine Excellence Physicians Surveys and Questionnaires Work setting medicine Humans Blood Transfusion 030212 general & internal medicine Hospice care media_common computer.programming_language Oncology (nursing) business.industry Palliative Care Anemia General Medicine United Kingdom Clinical trial Medical–Surgical Nursing Policy 030220 oncology & carcinogenesis Family medicine Practice Guidelines as Topic Female Erythrocyte Transfusion business Ireland computer |
Zdroj: | BMJ Supportive & Palliative Care. :bmjspcare-2018 |
ISSN: | 2045-4368 2045-435X |
DOI: | 10.1136/bmjspcare-2018-001494 |
Popis: | Objectives Red cell (blood) transfusions are used in palliative care to manage patients with symptomatic anaemia or when patients have lost blood. We aimed to understand current blood transfusion practice among palliative medicine doctors and compare this with National Institute for Health and Care Excellence (NICE) guidance. NICE guidance advocates more restrictive transfusion practice but is based on clinical trials in non-palliative care contexts; the extent to which these findings should be applied to palliative care remains unclear. Methods Four clinical vignettes of common clinical palliative care scenarios were developed. Members of the Association for Palliative Medicine were invited to complete the survey. Results were compared with acceptable responses based on current NICE recommendations and analysed to determine the influence of respondents’ gender, experience or work setting. Results 27% of 1070 members responded. Overall, ideal or acceptable responses were selected by less than half of doctors to all four vignettes. Doctors were more liberal in prescribing blood transfusions than NICE guidance would advocate. Senior doctors were less likely to choose an acceptable response than junior colleagues. Conclusion Palliative care practice is varied and not consistent with a restrictive blood transfusion policy. More recently trained doctors follow less liberal practices than senior colleagues. More direct evidence of benefits and harms of blood transfusion is needed in palliative care to inform practice. |
Databáze: | OpenAIRE |
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