Retrospective audit to assess iron Deficiency testing and screening in adult Medical Oncology Patients in regional New South Wales
- Background and Aims
Oncology patients are vulnerable to iron deficiency from disease and treatment factors. Iron deficiency correlates with poorer outcomes, higher morbidity and mortality, and reduced quality of life, and yet this test is often missed. The aim of this audit was to assess whether iron testing rates can be improved by routine screening policy compared with ad hoc physician-initiated testing, and to determine the prevalence of absolute and functional iron deficiency in regional Australian patients with solid tumours.
- Methods
Audit with chart review of all patients seen in Maitland Hospital Oncology Clinics from 01/06/2023-30/11/2023. We collected blood results, diagnosis, treatment and demographic information and analysed in Excel and Stata. We initiated standardised iron deficiency testing within the three-month period 1/09/2023 to the 30/11/2023 and compared this with ad-hoc testing from the 1/06/2023 – 31/08/2023
- Results
The proportion of patients tested for iron deficiency increased from 4% (9/213 patients) when requested according to physician choice to 49% (103/211) post-standardisation of testing with a p value <0.001 using Fishers exact test. In our study, 21/103(20.4%) of patients tested had absolute iron deficiency with Ferritin <100 and TSAT <20 and 41/103(42%) had functional iron deficiency. Adult patients who were iron deficient in our sample were 60% non-curative intent and 35% curative intent, 5% non-classifiable. 24% of the iron deficient population were identified as female and 19.5% were identified as male.
Correction of iron deficiency in solid tumour patients is recommended by guidelines. Implementation of routine testing can improve compliance with these guidelines and identify patients which may be iron deficient.