National comparative audit of red blood cell transfusion practice in hospices: Recommendations for palliative care practice

Sage Palliative Medicine & Chronic Care

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: [e-mail]