Ferritin measurement IN Donors – Effectivity of iron Monitoring to diminish iron deficiency and low haemoglobin (FIND’EM)
An appropriate policy for iron monitoring is important for blood services worldwide. FIND’EM was designed for the purpose of evaluating Sanquin's ferritin policy, which was implemented in 2017.
Implementation was done following a stepped wedge cluster-randomized trial approach. This pragmatic design involves random and sequential crossover of clusters (donation centers or regions) from control (the existing policy without ferritin measurements) to intervention (the ferritin measurement policy), until all clusters are exposed to the intervention. We evaluated the effects of the intervention in terms of ferritin and Hb levels, low-Hb deferral rates, donor availability, costs and donor health. For this project we made use of routinely collected data from the blood bank information system, extended with data from questionnaires and additional ferritin measurements in randomly selected samples of donors at various time points across the blood donation clusters.
The FIND’EM study found that ferritin-guided donation intervals effectively increased donor hemoglobin and ferritin levels and decreased the odds of hemoglobin-based deferral and iron deficiency. We also found that this policy decreased the odds of donor return over time and no effect on iron deficiency related symptoms.
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