Table of Contents
ISRN Hematology
Volume 2012 (2012), Article ID 524513, 12 pages
http://dx.doi.org/10.5402/2012/524513
Research Article

Transfusion Practices in the Management of Sickle Cell Disease: A Survey of Florida Hematologists/Oncologists

1Division of Hematology/Oncology, Department of Pediatrics, University of Florida, Box 100296, Gainesville, FL 32610, USA
2Division of Hematology/Oncology, Department of Medicine, University of Florida, Box 100278, Gainesville, FL 32610, USA
3Department of Pharmaceutical Outcomes and Policy, University of Florida, Box 100496, Gainesville, FL 32610, USA

Received 24 April 2012; Accepted 7 August 2012

Academic Editors: B. T. Gjertsen, S. Koschmieder, and G. Lucarelli

Copyright © 2012 Levette N. Dunbar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The purpose of this study was to characterize transfusion practices in the management of sickle cell disease and to identify factors attributing to differences in prescribing practices among Florida hematologists/oncologists. A cross-sectional study was performed in 2005-2006 utilizing a mail survey. The survey instrument addressed practice characteristics, sickle cell patient populations, transfusion settings, indications and techniques, red blood cell phenotype specifications/modifications, use of practice guidelines, and educational resource utilization. One hundred fifty two physicians (75% adult-oriented, 25% pediatric) completed the survey. Non-academic practice settings (78 %) were the primary location. Pediatric practices had a larger percentage of patients with overt strokes, and receiving hydroxyurea therapy than adult-oriented practices. The majority of survey respondents did not request limited phenotypically matched red blood cells on a routine basis. The majority of pediatric practices (60%) had individually defined transfusion practice guidelines in contrast to 8% of adult-oriented practices. There were statistically significant differences for pediatric and adult-oriented practices in managing certain acute and chronic transfusion indications. Analysis of clinical vignette data revealed variation among hematologists/oncologists in the transfusion management of common clinical scenarios. The study underscores the need for the development and dissemination of comprehensive sickle cell transfusion guidelines and protocols.