Compliance of guidelines for the diagnosis of mycrocytic anemia at Damas Hospital: pilot study.

Abstract

Iron deficiency is the most common nutrient deficiency in the world. Serum ferritin measurement is considered the most reliable test for the diagnosis of Iron Deficiency Anemia. At our institution there seems to be non consensus in terms of the diagnostic workup for patients with microcytic anemia or the application of guidelines. The purpose of this investigation was to examine the compliance of guidelines for the diagnosis of microcytic anemia at Damas Hospital performed by admitting physicians when microcytic anemia is encountered; compared to the proposed algorithm by the American Academy of Family Physicians (AAFP). Of the patients included in the study 82% did not underwent ferritin studies, of this 79% did not underwent any other serum laboratories to assess the cause of the anemia. Of the patients who did not underwent any serum laboratories 18 went straight to colonoscopy without further work up. None of the patients who did undergo serum laboratories for anemia was further investigated with colonoscopy. In comparison with AAFP guidelines, none of the patients with microcytic anemia was adequately studied for the cause of disease. None of the guidelines or algorithms proposed establish a difference between what should be done depending on the setting in which a :patient is been studied either inatient or outpatient.