Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study
African Journal of Primary Health Care & Family Medicine
| Field | Value | |
| Title | Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study | |
| Creator | Adedayo, Temitope O'Mahony, Don Adeleke, Oluakyode Mabunda, Sikhumbuzo | |
| Description | Background: Unnecessary blood transfusion exposes recipients to potential harms.Aim: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion.Setting: A hospital providing level 1 and 2 services.Methods: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semi-structured interviews.Results: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs.Conclusion: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. | |
| Publisher | AOSIS | |
| Date | 2021-06-24 | |
| Identifier | 10.4102/phcfm.v13i1.2889 | |
| Source | African Journal of Primary Health Care & Family Medicine; Vol 13, No 1 (2021); 8 pages 2071-2936 2071-2928 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://phcfm.org/index.php/phcfm/article/view/2889/4715
https://phcfm.org/index.php/phcfm/article/view/2889/4716
https://phcfm.org/index.php/phcfm/article/view/2889/4717
https://phcfm.org/index.php/phcfm/article/view/2889/4718
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