PMID- 31305890 OWN - NLM STAT- MEDLINE DCOM- 20200325 LR - 20200325 IS - 1943-7722 (Electronic) IS - 0002-9173 (Linking) VI - 152 IP - 5 DP - 2019 Oct 7 TI - Restrictive Transfusion Strategy and Clinical Decision Support Practices for Reducing RBC Transfusion Overuse. PG - 544-557 LID - 10.1093/ajcp/aqz070 [doi] AB - OBJECTIVES: Assess support for the effectiveness of two separate practices, restrictive transfusion strategy and computerized physician order entry/clinical decision support (CPOE/CDS) tools, in decreasing RBC transfusions in adult surgical and nonsurgical patients. METHODS: Following the Centers for Disease Control and Prevention Laboratory Medicine Best Practice (LMBP) Systematic Review (A-6) method, studies were assessed for quality and evidence of effectiveness in reducing the percentage of patients transfused and/or units of blood transfused. RESULTS: Twenty-five studies on restrictive transfusion practice and seven studies on CPOE/CDS practice met LMBP inclusion criteria. The overall strength of the body of evidence of effectiveness for restrictive transfusion strategy and CPOE/CDS was rated as high. CONCLUSIONS: Based on these procedures, adherence to an institutional restrictive transfusion strategy and use of CPOE/CDS tools for hemoglobin alerts or reminders of the institution's restrictive transfusion policies are effective in reducing RBC transfusion overuse. CI - (c) American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Derzon, James H AU - Derzon JH AD - RTI International, Research Triangle Park, NC. FAU - Clarke, Nicole AU - Clarke N AD - Pharmerit International, Bethesda, MD. FAU - Alford, Aaron AU - Alford A AD - National Network of Public Health Institutes, Washington, DC. FAU - Gross, Irwin AU - Gross I AD - Acumen, San Diego, CA. FAU - Shander, Aryeh AU - Shander A AD - Englewood Hospital and Medical Center, Englewood, NJ. FAU - Thurer, Robert AU - Thurer R AD - Gauss Surgical, Los Altos, CA. LA - eng PT - Journal Article PT - Research Support, U.S. Gov't, P.H.S. PT - Systematic Review PL - England TA - Am J Clin Pathol JT - American journal of clinical pathology JID - 0370470 SB - IM MH - *Decision Support Systems, Clinical MH - Erythrocyte Transfusion/*statistics & numerical data MH - Humans MH - *Medical Order Entry Systems MH - Medical Overuse/*prevention & control MH - *Practice Guidelines as Topic MH - Quality Assurance, Health Care OTO - NOTNLM OT - Clinical decision support OT - Computerized physician order entry OT - Meta-analysis OT - RBC transfusion OT - Restrictive transfusion strategy OT - Systematic review EDAT- 2019/07/16 06:00 MHDA- 2020/03/26 06:00 CRDT- 2019/07/16 06:00 PHST- 2019/07/16 06:00 [pubmed] PHST- 2020/03/26 06:00 [medline] PHST- 2019/07/16 06:00 [entrez] AID - 5532293 [pii] AID - 10.1093/ajcp/aqz070 [doi] PST - ppublish SO - Am J Clin Pathol. 2019 Oct 7;152(5):544-557. doi: 10.1093/ajcp/aqz070.