Abstract
Introduction
Iron deficiency anaemia (IDA) is common in older people, but traditional ferritin cutoffs may not be applicable in older people and iron studies are increasingly being used to diagnose iron deficiency anaemia. We wish to update guidance for diagnosing IDA, but first wished to survey current knowledge.
Methods
Clinical staff working with older people were asked to filled in a survey. They answered questions relating to confidence in interpreting ferritin and iron studies. Their knowledge of interpreting iron studies was assessed with two multiple choice questions illustrating common scenarios.
Results
When asked on a scale of 1-5 how confident the 135 participants were at interpreting ferritin, the mean was 3.7. For iron studies, it was 3.2. Amongst consultants, the mean confidence in interpreting ferritin was 4.18, in doctors of other grades (excluding GPs) this was 3.5, and for other medical professionals (PAs, ACPs and pharmacists) 2.8. Regarding iron studies, the mean confidence in consultants was 3.7, 2.9 in doctors of other grades (excluding GPs), and 2.7 in other medical professions. 88% of consultants, 73% doctors of other grades (excluding GPs), and 65% of other healthcare professionals correctly answered the case on a patient with anaemia of chronic disease. 94% consultants, 88% doctors of other grades (excluding GPs), and 70% of other healthcare professionals correctly answered the case on a patient with IDA.
Conclusions
The data suggests that clinicians of all grades felt less confident in interpreting iron studies than ferritin. A significant proportion of medical professionals did not correctly interpret iron studies. We have consulted with our colleagues in haematology and gastroenterology and drafted a revised guideline to help interpretation, and suggest that IDA guidance should have advice on iron study interpretation. We will also examine IV iron prescription use and provide clear guidance on indications, tracking related costs.