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P076: Choosing Wisely: hemoglobin transfusions and the treatment of iron deficiency anemia

Published online by Cambridge University Press:  11 May 2018

C. Rice*
Affiliation:
Emergency Strategic Clinical Network, Alberta Health Services, Calgary, AB
H. Hair
Affiliation:
Emergency Strategic Clinical Network, Alberta Health Services, Calgary, AB
S. K. Dowling
Affiliation:
Emergency Strategic Clinical Network, Alberta Health Services, Calgary, AB
C. Joseph
Affiliation:
Emergency Strategic Clinical Network, Alberta Health Services, Calgary, AB
D. Grigat
Affiliation:
Emergency Strategic Clinical Network, Alberta Health Services, Calgary, AB
E. Lang
Affiliation:
Emergency Strategic Clinical Network, Alberta Health Services, Calgary, AB
*
*Corresponding author

Abstract

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Introduction: Choosing Wisely Canada has identified blood transfusions as a priority area for improving clinical appropriateness. Relevant recommendations include Dont transfuse blood if other non-transfusion therapies or observation would be just as effective. In parallel with this recommendation, the Alberta division of Towards Optimized Practice (ToP) has developed guidelines for the treatment of iron deficiency anemia (IDA) that emphasize the use of non-transfusion therapies (i.e. parenteral or oral iron, in appropriate patients). Choosing Wisely also emphasizes strategies to better engage patients in shared decision making. Methods: In order to better engage patients in shared decision making about their treatment options, both physician and patient handouts were developed using an iterative process. The development of the patient-facing documents began with a synthesis of educational materials currently available to patients with IDA. Clinical leaders from nine different specialties (Emergency Medicine, Family Medicine, Day Medicine, Hematology, and others) were continually engaged in the development of content using a consensus model. A focus group of ESCN patient advisors was assembled to review materials with an emphasis on: (1) Are the patient materials easily understood? (2) Are intended messages resonating while avoiding unintended messaging? (3) What information do patients require that has not been included? Following the focus group, revisions were made to patient materials and a subsequent online survey confirmed that the final version addressed any issues they had raised. Results: A four-page patient handout/infographic was developed utilizing best practices in information design, and in physician and patient engagement. Content includes the causes and symptoms of IDA, progressive treatment options from dietary changes to transfusion, and the four Choosing Wisely questions to discuss with your doctor. Conclusion: Patient education materials can be developed according to best practices in information design and stakeholder engagement. Patient focus groups demonstrate that such materials are easier to understand, and better equip patients to engage in shared decision making.

Type
Poster Presentations
Copyright
Copyright © Canadian Association of Emergency Physicians 2018