title: Transfusion practices in the management of sickle cell disease: a survey of Florida hematologists/oncologists.
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.
authors: Division of Hematology/Oncology, Department of Pediatrics, University of Florida, Box 100296, Gainesville, FL 32610, USA.
authors: Levette N
authors: LN
authors: Dunbar
authors: Larae
authors: L
authors: Coleman Brown
authors: Donna R
authors: DR
authors: Rivera
authors: Abraham G
authors: AG
authors: Hartzema
authors: Richard
authors: R
authors: Lottenberg