Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland
Objectives: Restrictive blood transfusion policy has been shown to be effective in managing anemia. However, treatment of anemia in palliative (PC) and end-of-life (EOL) care remains understudied. The aim of this study was to examine Finnish PC physicians’ attitudes and practices in the management o...
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| Language: | English |
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Mary Ann Liebert
2024-10-01
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| Series: | Palliative Medicine Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/pmr.2024.0050 |
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| author | Reino Pöyhiä Sari Hämäläinen Karen Neoh Annamarja Lamminmäki |
| author_facet | Reino Pöyhiä Sari Hämäläinen Karen Neoh Annamarja Lamminmäki |
| author_sort | Reino Pöyhiä |
| collection | DOAJ |
| description | Objectives: Restrictive blood transfusion policy has been shown to be effective in managing anemia. However, treatment of anemia in palliative (PC) and end-of-life (EOL) care remains understudied. The aim of this study was to examine Finnish PC physicians’ attitudes and practices in the management of anemia. Methods: A structured questionnaire asking clinicians about how they treat anemia in PC was developed with a focus on blood transfusion. In addition, a previously published collection of clinical case scenarios was included. Physician’s recall of their use of red blood cell (RBC) transfusions in 2021 was also asked. The questionnaire was first delivered at an annual meeting of the Finnish Association for Palliative Medicine in 2022 and subsequently, a Webpropol form was emailed to the members of the society. Results: A total of 94 (28%) doctors at an average age of 46.5 years responded. Of these 80% were specialists and 75% had a special competence in palliative medicine. RBC transfusions were given in less than 25% of patients, average hemoglobin was b ≤ 78 g/L. Transfusions were given for clinical symptoms such as fatigue, angina, and weakness without systematic measurement of symptom severity. Hematinic levels were investigated, but iron was given seldom. Clinical scenarios were answered similarly as previously in the UK. National guidelines for anemia in early PC or EOL care are lacking but would be deemed to be helpful by one-third of those who completed the questionnaire. Conclusion: Physicians apply the restrictive policy in blood transfusions for PC patients in Finland. Other treatments for anemia are not often used. Both prospective studies and national guidelines are needed. |
| format | Article |
| id | doaj-art-b82e6e1e209e41eeb304e2008cf8a1c7 |
| institution | Kabale University |
| issn | 2689-2820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj-art-b82e6e1e209e41eeb304e2008cf8a1c72025-08-20T03:49:37ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015157858410.1089/pmr.2024.0050Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in FinlandReino Pöyhiä0Sari Hämäläinen1Karen Neoh2Annamarja Lamminmäki3Department of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.Department of Medicine, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland.St Gemma’s Hospice, Leeds, United Kingdom.Departments of Oncology and Palliative Care, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.Objectives: Restrictive blood transfusion policy has been shown to be effective in managing anemia. However, treatment of anemia in palliative (PC) and end-of-life (EOL) care remains understudied. The aim of this study was to examine Finnish PC physicians’ attitudes and practices in the management of anemia. Methods: A structured questionnaire asking clinicians about how they treat anemia in PC was developed with a focus on blood transfusion. In addition, a previously published collection of clinical case scenarios was included. Physician’s recall of their use of red blood cell (RBC) transfusions in 2021 was also asked. The questionnaire was first delivered at an annual meeting of the Finnish Association for Palliative Medicine in 2022 and subsequently, a Webpropol form was emailed to the members of the society. Results: A total of 94 (28%) doctors at an average age of 46.5 years responded. Of these 80% were specialists and 75% had a special competence in palliative medicine. RBC transfusions were given in less than 25% of patients, average hemoglobin was b ≤ 78 g/L. Transfusions were given for clinical symptoms such as fatigue, angina, and weakness without systematic measurement of symptom severity. Hematinic levels were investigated, but iron was given seldom. Clinical scenarios were answered similarly as previously in the UK. National guidelines for anemia in early PC or EOL care are lacking but would be deemed to be helpful by one-third of those who completed the questionnaire. Conclusion: Physicians apply the restrictive policy in blood transfusions for PC patients in Finland. Other treatments for anemia are not often used. Both prospective studies and national guidelines are needed.https://www.liebertpub.com/doi/10.1089/pmr.2024.0050anemiaend-of-life carepalliative caretransfusion |
| spellingShingle | Reino Pöyhiä Sari Hämäläinen Karen Neoh Annamarja Lamminmäki Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland Palliative Medicine Reports anemia end-of-life care palliative care transfusion |
| title | Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland |
| title_full | Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland |
| title_fullStr | Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland |
| title_full_unstemmed | Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland |
| title_short | Restrictive Blood Transfusion Policy for the Management of Anemia in Palliative Care in Finland |
| title_sort | restrictive blood transfusion policy for the management of anemia in palliative care in finland |
| topic | anemia end-of-life care palliative care transfusion |
| url | https://www.liebertpub.com/doi/10.1089/pmr.2024.0050 |
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