title: Change in therapeutic apheresis practices: Role of continuing medical education (CME).
abstract: BACKGROUND
  American society for apheresis (ASFA) publishes guidelines for therapeutic apheresis (TA) and physicians ordering TA procedures should be aware of the appropriate indications based on scientific evidence. Transfusion Medicine specialists (apheresis physicians) can steer physicians in right direction through CME on right indications, duration of therapy and replacement fluid. Therefore, authors reviewed, collated, and interpreted effect of formal CME interventions.
  
  
  METHODS
  Retrospective study was conducted in a large hospital in India. CME interventions to teach clinical and managerial aspects of TA were conducted in the first quarter of 2012. Sessions involved ASFA guidelines and recommendations for TA. Data was collected and changes in practice related to TA before (March 2010 to December 2011) and after (April 2012 to December 2013) the intervention was analyzed.
  
  
  RESULTS
  Seventy-three subjects participated in the interventions. Five hundred and eighty-nine TA procedures were performed during study period; 214 procedures in 49 patients before intervention and 375 procedures in 84 patients after intervention. After intervention there was significant improvement in indications of category I (38.7% vs. 64.3%; P = 0.004), category II (22.5% vs. 16.6%), category III (12.2% vs. 11.9%), and category IV (6.1% vs. 2.4%; P = 0.0001). Significant reduction was seen in procedures not belonging to any category from 20.5% to 4.8% (P = 0.002). Change in practices was also observed in context of duration of therapy and replacement fluid.
  
  
  CONCLUSIONS
  CME intervention, based on the 2010 edition of ASFA guidelines for therapeutic apheresis appears to have had a positive impact on physicians TA practices.
authors: Department of Transfusion Medicine, Medanta-the Medicity, Gurgaon, India.
authors: Aseem Kumar
authors: AK
authors: Tiwari
authors: Department of Transfusion Medicine, Medanta-the Medicity, Gurgaon, India.
authors: Ravi C
authors: RC
authors: Dara
authors: Department of Transfusion Medicine, Jaypee Hospital, Greater Noida, India.
authors: Prashant
authors: P
authors: Pandey
authors: Department of Transfusion Medicine, Medanta-the Medicity, Gurgaon, India.
authors: Dinesh
authors: D
authors: Arora
authors: Department of Transfusion Medicine, Medanta-the Medicity, Gurgaon, India.
authors: Ganesh
authors: G
authors: Rawat
authors: Laboratory Services and Transfusion Medicine, Medanta-the Medicity, Gurgaon, India.
authors: Vimarsh
authors: V
authors: Raina
mesh_terms: D000328:Adult; D001781:Blood Component Removal / Q000379:methods* / Q000639:trends; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D010951:Plasma Exchange / Q000639:trends; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D014481:United States
keywords: American society for apheresis (ASFA); apheresis; therapeutic plasma exchange