Project aims to improve diagnosis and treatment for patients with anaemia
Ambulatory care specialists at the University of Birmingham, with support from Vifor Pharma UK Limited (VPUK), are working to develop and implement a population based anaemia diagnosis and treatment decision support service for routine healthcare delivery.
Anaemia is one of the most common laboratory abnormalities in both community and hospital settings. Anaemia is associated with a range of poorer health outcomes, including poorer quality of life, hospital admission, progression to institutional long term care and death yet there is evidence of inadequate use of tests to determine the cause of anaemia, leaving patients without a confirmed underlying diagnosis.
The new quality improvement project, led by Professor Dan Lasserson of the University of Birmingham and Sandwell and West Birmingham Hospitals NHS Trust, aims to construct a decision support algorithm to reduce the proportion of patients with inadequate investigation for anaemia. This will ensure the right combination of tests are performed for patients with anaemia detected for the first time, as well as reduce over-investigation where information is already contained within existing results in the laboratory database. The algorithm will, therefore, support rational diagnostic testing for anaemia, using existing resources tailored to the local population.
The algorithm guidance will be developed in conjunction with haematologists, acute physicians, gastroenterologists, and GPs, to ensure that the outputs are delivered in a usable and effective format, using electronic health records, enabling maximum generalisability across primary and secondary care.
Vifor Pharma, a leader in iron deficiency therapy, has provided financial support to this quality improvement programme.
Nick Ibrahim, VPUK general manager, commented: "Irrespective of the effective treatments available, Vifor UK is proud to support a project that will allow better identification and management of people with iron deficiency and anaemia, with the potential to provide significant benefits to thousands of patients and the healthcare system in general."
Dan Lasserson, professor of ambulatory care at the University of Birmingham's Institute of Applied Health Research, explained: "Anaemia is associated with a range of poorer health outcomes and seen commonly in community and hospital settings, but despite this, there is wide variation in approaches to diagnosis and management.
"Developing a population-based anaemia detection, diagnosis and management tool will standardise care to the large and diverse population in Birmingham, and ensure that at every healthcare contact, patients will have the right tests performed to find the underlying cause of anaemia."
Ugo Lucca et al. Association of Mild Anemia with Cognitive, Functional, Mood and Quality of Life Outcomes in the Elderly: The "Health and Anemia" Study, PLoS ONE (2008). DOI: 10.1371/journal.pone.0001920
David McCartney et al. The evaluation of anaemia in an older primary care population: retrospective population-based study, BJGP Open (2017). DOI: 10.3399/bjgpopen17X101157