Abstract
BackgroundA significant percentage of red blood cell transfusions are inappropriately overused. This study investigated physicians from the western Galilee in terms of their knowledge of transfusion medicine as a potential reason for red blood cell overuse, and assessed the influence of personal background characteristics on their knowledge.MethodsData were collected via anonymous questionnaires. The questionnaires included a personal background section and a professional section. Study participants were grouped according to field of specialty, seniority, and location of medical school graduation, in order to correlate participant characteristics with knowledge.ResultsScores were calculated on a 0–100 scale. The overall knowledge of the study population was low (mean score 47.8 ± 18.6). Knowledge regarding basic physiology of red blood cell transfusion was also low. Internal medicine physicians and senior physicians had significantly greater overall knowledge scores and were more familiar with a restrictive blood management policy than were surgeons and residents, respectively. Comparing knowledge scores, no difference was found regarding indications for transfusion.ConclusionGeneral and fundamental knowledge in transfusion medicine is lacking among physicians in the non-operating room setting, which may play a role in red blood cell transfusion overuse. Field of specialty and professional status influenced knowledge of transfusion medicine. Educational programs and increased physicians’ awareness might help decrease unnecessary transfusions.Trial registrationNot applicable.
Highlights
A significant percentage of red blood cell transfusions are inappropriately overused
Despite the risks and high costs associated with red blood cell (RBC) transfusion [1, 2], the Joint Commission along with the American Medical Association has included blood transfusions in a list of the five most overused therapeutic procedures in the United States [3], where 15 million blood units are given per annum
A landmark study among intensive care unit patients established by the Canadian Critical Care Trials group (TRICC trial), showed that a restrictive RBC transfusion strategy is at least as effective as and possibly superior to a liberal transfusion strategy for critically ill patients [6]
Summary
A significant percentage of red blood cell transfusions are inappropriately overused. This study investigated physicians from the western Galilee in terms of their knowledge of transfusion medicine as a potential reason for red blood cell overuse, and assessed the influence of personal background characteristics on their knowledge. The decision to transfuse RBCs followed a liberal approach, which was to maintain blood hemoglobin concentration above 10 g/dl. Reevaluation of this threshold trigger raised fundamental issues regarding its arbitrariness, as well as a lack of evidence [4, 5] for the basis of many aspects of transfusion practice, when compared with other fields of medicine. A growing number of international studies comparing a restrictive blood management approach A landmark study among intensive care unit patients established by the Canadian Critical Care Trials group (TRICC trial), showed that a restrictive RBC transfusion strategy is at least as effective as and possibly superior to a liberal transfusion strategy for critically ill patients (with the possible exclusion of patients with acute coronary syndrome) [6].
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