Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel

Authors

  • António Robalo Nunes Hospital das Forças Armadas. Lisboa. Anemia Working Group Portugal. Lisboa.
  • Dialina Brilhante Anemia Working Group Portugal. Lisboa. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa.
  • Ana Macedo Keypoint, Consultoria Científica. Lisboa. Faculdade de Medicina e Ciências Biomédicas. Universidade do Algarve. Faro.
  • Vera Beato Hospital das Forças Armadas. Lisboa.
  • Diana Gomes Centro Hospitalar de Vila Nova de Gaia/Espinho. Gaia.
  • José Gonçalves-Aguiar Hospital dos Lusíadas. Porto.
  • Fátima Lima Centro Hospitalar de Vila Nova de Gaia/Espinho. Gaia.
  • João Mairos Anemia Working Group Portugal. Lisboa. Direção de Saúde da Força Aérea. Lisboa.
  • Teresa Melo-Lencastre Centro Hospitalar de Vila Nova de Gaia/Espinho. Gaia.

DOI:

https://doi.org/10.20344/amp.17518

Keywords:

Anemia, Iron-Deficiency, Biomarkers/ blood, Blood Transfusion, Consensus, Iron Deficiencies, Perioperative Care

Abstract

Introduction: Anaemia and iron deficiency are associated with increased mortality and poor surgical outcomes. Consensus in their definitions is expected to optimize their management, which is encompassed by patient blood management, providing patient-centred care while improving patient safety and clinical outcomes. Patient blood management implementation is even more relevant in contingency times and faces barriers due to lack of standardization, among others. The aim is to establish a consensus on these diagnoses and implement patient blood management principles in clinical practice in Portugal.
Material and Methods: Eight experts in Transfusion Medicine, Haematology, Anaesthesiology, Internal Medicine, and Obstetrics/Gynaecology were assembled; a focus group was conducted, defining 33 statements. A Delphi panel was conducted, with experts from the clinical specialities named above as well as from General Surgery, Urology, and Orthopaedics.
Results: The Delphi panel’s rounds had 70 (Round 1) and 46 (Round 2) respondents. Specialists were consensual in only two statements, on the existence of a preoperative patient blood management consultation for candidates to elective surgeries in which the use of blood derivatives is anticipated and, on the importance of the correction of postoperative anaemia and iron deficiency. Of the remaining 31 statements, 27 reached high agreement or disagreement by the respondents.
Conclusion: Consensus was reached in only two (6%) of the 33 statements. There was a consensual agreement on the relevance of establishing patient blood management as the standard of care and of valuing preoperative and postoperative patient blood management interventions. Nevertheless, our results point to the lack of awareness regarding patient blood management principles – which could result in better postoperative outcomes, shorter hospitalizations, reduced costs and increased availability of beds. Training and literacy initiatives could help further implement patient blood management standards in Portuguese hospitals.

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Author Biography

António Robalo Nunes, Hospital das Forças Armadas. Lisboa. Anemia Working Group Portugal. Lisboa.

Professor Auxiliar Convidada da Faculdade de Medicina at Universidade do Algarve
Universidade do Algarve   Universitat Autònoma de Barcelona

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Published

2022-05-27

How to Cite

1.
Robalo Nunes A, Brilhante D, Macedo A, Beato V, Gomes D, Gonçalves-Aguiar J, Lima F, Mairos J, Melo-Lencastre T. Improving Awareness about Patient Blood Management in Portugal: A Call for Action Arising from a Delphi Panel. Acta Med Port [Internet]. 2022 May 27 [cited 2022 Nov. 30];35(10):749-57. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/17518

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Original