Iron deficiency treatment pathway in Italy: patients' perceptions of diagnosis and treatment.

Abstract

Aim: This 2023 online survey assessed the management of patients with iron deficiency anemia/iron deficiency without anemia (IDA/IDWA) in Italy. Materials & methods: The study used the patient's perspective to examine care pathways used to manage IDA/IDWA in Italy, to raise clinician awareness, improve patient care (earlier diagnosis, initiate appropriate treatment) and outcomes (reduce recurrence/progression). The survey questioned iron deficiency (ID) diagnoses of patients, their sources of information and influence, their knowledge of ID, perceptions and fears surrounding treatment, unmet needs and expectations, and underlying causes of treatment compliance and persistence. Results: Of the 404 respondents (102 males and 302 females) who completed the survey, all were aged between 18 and 80 years. Almost all respondents (97.0%) experienced ID symptoms, most frequently fatigue, weakness and tiredness (71.0% of the total cohort; 80.1% females vs 44.1% males); 76.8% of all respondents regarded symptoms as 'bothersome'. Most respondents (70.5%) consulted a physician as the first action to treat ID (79.8% females vs 43.1% males); general practitioners were the main healthcare providers, consulted by 55.6% of all respondents. Most respondents (94.1%) were aware of potential ID recurrence, and 75.0% reported recurrent ID episodes since their diagnosis. Satisfaction with ID treatment was rated as average (7-7.7/10); 56.4% of all respondents stayed on ID treatment for as long as prescribed, and 41.1% did not fully comply with tablet intake, primarily because they 'felt much better' (64.8%). Conclusion: This survey identified high rates of self-reported ID symptoms and recurrent ID episodes among respondents. It highlights the importance of increasing awareness of ID and its consequences among healthcare practitioners and individuals in the general population, of shortening the time before diagnosis, and ensuring that patients continue treatment for the prescribed duration to resaturate serum iron levels. What is this article about? Iron deficiency (ID) is a condition in which a person does not have enough iron in their body to maintain adequate levels of healthy red blood cells, for reasons such as heavy menstrual bleeding, low dietary iron intake or poor iron absorption. ID often leads to anemia, when there are not enough healthy red blood cells carrying oxygen throughout the body. Iron deficiency anemia (IDA) is very common, as is iron deficiency without anemia (IDWA). Untreated IDA can lead to severe health problems, including extreme fatigue, weakness, hair loss and rapid heart rate, so the proper management of IDA is important. Diagnosing IDA and IDWA is complicated by inadequate screening recommendations, a lack of awareness of IDWA among healthcare practitioners (HCPs), and the clinical signs and symptoms of ID are often ignored. HCPs also differ widely in their choice of iron compounds for managing IDA and IDWA. This paper describes findings from a survey among adults in Italy diagnosed with IDA or IDWA and treated in the past 12 months with prescription medication. What were the results? Most survey respondents did not know their ID status prior to diagnosis and after receiving an ID treatment the main reason for no compliance was because the patient felt better. Why is this important? The findings suggest that both HCPs and the general population need to be more aware of ID and its consequences, and how to manage ID. HCPs can play a vital role in educating and supporting patients on ID treatment, to improve their understanding about managing their disease and continuing treatment for as long as is needed.