Oct 15, 2018
This episode features Dr Karen Neoh (St Gemma’s Academic
Unit of Palliative Care, University of Leeds, Leeds, UK).
This national audit aimed to determine national transfusion
practice in hospices and compare this against National Institute
for Health and Care Excellence and British Society of
Haematology guidelines to develop recommendations to improve
practice.
The results demonstrated that patients are not usually investigated
for the cause of their anaemia, of those that were a significant
proportion would have benefitted from B12, folate or iron
supplementation, although these were rarely used. Transfusion
practice remains too liberal despite greater risks of
transfusion-associated circulatory overload in patients with
advanced disease. Only 18% of transfused patients had an
improvement maintained up to 30 days; 42% had no or very
transient benefit, and 32% were dead at 30 days. The authors
conclude that more rigorous investigation of anaemia, increased use
of alternative therapies and a more restrictive approach to
red blood cell transfusions are needed. Furthermore, clinicians
should discuss with patients the limited benefit versus higher
risks of red blood cell transfusion in this patient group to
inform treatment decisions and ensure informed consent.
Full paper available from:
http://journals.sagepub.com.liverpool.idm.oclc.org/doi/full/10.1177/0269216318801755
If you would like to record a podcast about your published (or
accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:
anwosu@liverpool.ac.uk