Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes
Abstract Background Blood transfusion in chronic anemia is not covered by guidelines specific to older adults. When they consider that this treatment is necessary in elderly patients, French general practitioners (GPs) contact a hospital specialist to plan a transfusion. Methods Twenty French GPs we...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | BMC Family Practice |
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| Online Access: | http://link.springer.com/article/10.1186/s12875-017-0647-8 |
| _version_ | 1811327092367818752 |
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| author | Sylvain Le Calvé Dominique Somme Joaquim Prud’homm Aline Corvol |
| author_facet | Sylvain Le Calvé Dominique Somme Joaquim Prud’homm Aline Corvol |
| author_sort | Sylvain Le Calvé |
| collection | DOAJ |
| description | Abstract Background Blood transfusion in chronic anemia is not covered by guidelines specific to older adults. When they consider that this treatment is necessary in elderly patients, French general practitioners (GPs) contact a hospital specialist to plan a transfusion. Methods Twenty French GPs were questioned individually regarding their approach to blood transfusion using semi-structured interviews. Each interview was recorded, typed up verbatim and then coded using an inductive procedure by theme, in a cross-over design (two researchers) in two phases: analysis and summary, followed by grouping of the recorded comments. Results The criteria for transfusion were hemoglobin level < 8 g/dL and cardiac comorbidities. Some geriatric issues, such as cognitive disorder or dependence, were considered, either as aspects of frailty favoring transfusion or as markers of reduced life expectancy that limit care. Falls and fear of an unpleasant death from anemia prompted GPs to order blood transfusion. The patient’s family provided guidance, but the patient was not routinely consulted. The specialists were rarely asked to participate in decision making. GPs’ perceptions were ambivalent: they considered transfusion to be extraordinary and magical, but also pointless since its effects are transient. Conclusion The decision to give a transfusion to an elderly patient with chronic anemia is deemed complex, but GPs seem to take it alone, sometimes guided by the patient’s family. The drawing up of an advance care plan could help involve the patient in decision making. |
| first_indexed | 2024-04-13T15:00:34Z |
| format | Article |
| id | doaj.art-dc3791429c3d41bb807caad0d79b2eb6 |
| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-13T15:00:34Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Family Practice |
| spelling | doaj.art-dc3791429c3d41bb807caad0d79b2eb62022-12-22T02:42:19ZengBMCBMC Family Practice1471-22962017-07-011811810.1186/s12875-017-0647-8Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudesSylvain Le Calvé0Dominique Somme1Joaquim Prud’homm2Aline Corvol3Unité de Soins de Longue Durée, Centre Hospitalier de Saint MaloCHU de Rennes, Service de gériatrieCHU de Rennes, Service de gériatrieCHU de Rennes, Service de gériatrieAbstract Background Blood transfusion in chronic anemia is not covered by guidelines specific to older adults. When they consider that this treatment is necessary in elderly patients, French general practitioners (GPs) contact a hospital specialist to plan a transfusion. Methods Twenty French GPs were questioned individually regarding their approach to blood transfusion using semi-structured interviews. Each interview was recorded, typed up verbatim and then coded using an inductive procedure by theme, in a cross-over design (two researchers) in two phases: analysis and summary, followed by grouping of the recorded comments. Results The criteria for transfusion were hemoglobin level < 8 g/dL and cardiac comorbidities. Some geriatric issues, such as cognitive disorder or dependence, were considered, either as aspects of frailty favoring transfusion or as markers of reduced life expectancy that limit care. Falls and fear of an unpleasant death from anemia prompted GPs to order blood transfusion. The patient’s family provided guidance, but the patient was not routinely consulted. The specialists were rarely asked to participate in decision making. GPs’ perceptions were ambivalent: they considered transfusion to be extraordinary and magical, but also pointless since its effects are transient. Conclusion The decision to give a transfusion to an elderly patient with chronic anemia is deemed complex, but GPs seem to take it alone, sometimes guided by the patient’s family. The drawing up of an advance care plan could help involve the patient in decision making.http://link.springer.com/article/10.1186/s12875-017-0647-8AnemiaTransfusionElderlyGPDecisionReferral |
| spellingShingle | Sylvain Le Calvé Dominique Somme Joaquim Prud’homm Aline Corvol Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes BMC Family Practice Anemia Transfusion Elderly GP Decision Referral |
| title | Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes |
| title_full | Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes |
| title_fullStr | Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes |
| title_full_unstemmed | Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes |
| title_short | Blood transfusion in elderly patients with chronic anemia: a qualitative analysis of the general practitioners’ attitudes |
| title_sort | blood transfusion in elderly patients with chronic anemia a qualitative analysis of the general practitioners attitudes |
| topic | Anemia Transfusion Elderly GP Decision Referral |
| url | http://link.springer.com/article/10.1186/s12875-017-0647-8 |
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