Validity of donor‐reported iron supplementation practices obtained at the time of donation

Abstract

Background Iron supplementation (IS) improves blood donors' iron stores and allows more frequent blood donation. Understanding the accuracy of self‐reported IS is helpful for potential application of IS practices to donor eligibility or donation intervals. Methods Successful whole blood and red cell apheresis donors completed a survey at donation on the use of select dietary supplements. Respondents reporting use of either iron pills (IP) or multivitamins (MV) were invited by email to complete a similar follow‐up survey 6–8 weeks later and to provide the quantitative iron content of IS by referring the donor to the pill bottle label. Consistency between baseline and follow‐up responses was assessed overall and by pill type and demographic variables. Results Of 2444 donors answering the baseline survey, 40% (978) reported MV or IP at donation, 354 of whom completed the follow‐up survey. A majority of survey respondents (56%–61%) reported taking iron across the two surveys, and 21%–24% took MV but were uncertain if their pills contained iron. Of 215 reporting IS at baseline, overall concordance at follow‐up was 68% and was higher for donors who were female, ≥50‐years old, and taking iron as an iron pill rather than in a multivitamin. Conclusion Consistency of donor responses may be insufficient for use in guiding donor eligibility. Referring donors to their pill bottles was unsuccessful in improving the high frequency of uncertain responses. Incorporating IS into donor eligibility determinations is a complex endeavor that will benefit from careful planning and from post‐implementation monitoring.

A rapid review of strategies to manage low iron levels in adults donating whole‐blood: A focus on donor behaviour

“…Twenty-one studies focused on donor acceptability of iron management strategies. [12][13][14]16,17,19,20,22,23,[25][26][27][28][29][30][31][32][33][34][35][36] For oral IS (11 studies), 65%-88% of donors accepted the course of IS offered by the BCA 25,31 and compliance with the recommended dose ranged from 58% to 100%. 23,26,27,31,33,34,37 Nwagha et al 36 used a modified Morisky medication adherence scale (5 'yes' 'no' questions that measure adherence to medication provision and 3 'yes' 'no' questions that tested motivation to adhere to medication) to measure adherence to IS and found that motivation to adhere (78%; score of 141 out of 180) and knowledge of the importance of adherence (88%; score of 106 out of 120) was high.…”

“…Three studies investigated donor knowledge of iron health and self-reported use of IS without additional interventions (i.e., descriptive studies). 16,28,30 Steele et al 16 found that 31% of donors recalled reading information about iron in routinely distributed pre-and post-donation materials. Further, the three studies 16,28,30 found that 21%-38% reported taking some form of IS either as a multivitamin (13%-29%), a separate supplement (4%-5%) or both (3%-4%).…”

“…16,28,30 Steele et al 16 found that 31% of donors recalled reading information about iron in routinely distributed pre-and post-donation materials. Further, the three studies 16,28,30 found that 21%-38% reported taking some form of IS either as a multivitamin (13%-29%), a separate supplement (4%-5%) or both (3%-4%). In all three studies, women were more likely to report taking IS than men.…”

“…Eighteen articles reported on the effects of iron management strategies on donor retention. 13,14,16,22,23,[25][26][27][28][29][30][31][33][34][35][36][37][38] Regarding oral IS, Bryant and colleagues 26 found that 72% of donors deferred for low Hb and offered oral IS returned within 39 months (the return rate of the control group was not reported). Further, these donors donated more units of WB per year than the general WB donor population.…”