Change in therapeutic apheresis practices: Role of continuing medical education (CME)

• Published in: Journal of clinical apheresis 2016-02, Vol.31 (1), p.16-21
• Main Authors: Tiwari, Aseem Kumar, Dara, Ravi C., Pandey, Prashant, Arora, Dinesh, Rawat, Ganesh, Raina, Vimarsh
• Format: Article
• Language: English
• Subjects: Adult; American society for apheresis (ASFA); apheresis; Blood Component Removal - methods; Blood Component Removal - trends; Education, Medical, Continuing; Female; Humans; India; Male; Plasma Exchange - trends; Practice Guidelines as Topic; Societies, Medical; therapeutic plasma exchange; United States
• ISSN: 0733-2459; 1098-1101
• DOI: 10.1002/jca.21397

Introduction American society for apheresis (ASFA) publishes guidelines for therapeutic apheresis (TA) and physicians ordering TA procedures should be aware of the appropriate indications based on scientific evidence. Transfusion Medicine specialists (apheresis physicians) can steer physicians in right direction through CME on right indications, duration of therapy and replacement fluid. Therefore, authors reviewed, collated, and interpreted effect of formal CME interventions. Materials and Methods Retrospective study was conducted in a large hospital in India. CME interventions to teach clinical and managerial aspects of TA were conducted in the first quarter of 2012. Sessions involved ASFA guidelines and recommendations for TA. Data was collected and changes in practice related to TA before (March 2010 to December 2011) and after (April 2012 to December 2013) the intervention was analyzed. Results Seventy‐three subjects participated in the interventions. Five hundred and eighty‐nine TA procedures were performed during study period; 214 procedures in 49 patients before intervention and 375 procedures in 84 patients after intervention. After intervention there was significant improvement in indications of category I (38.7% vs. 64.3%; P = 0.004), category II (22.5% vs. 16.6%), category III (12.2% vs. 11.9%), and category IV (6.1% vs. 2.4%; P = 0.0001). Significant reduction was seen in procedures not belonging to any category from 20.5% to 4.8% (P = 0.002). Change in practices was also observed in context of duration of therapy and replacement fluid. Conclusion CME intervention, based on the 2010 edition of ASFA guidelines for therapeutic apheresis appears to have had a positive impact on physicians TA practices. J. Clin. Apheresis 31:16–21, 2016. © 2015 Wiley Periodicals, Inc.