A clinical audit of thalassaemia management at the Lady Ridgeway Hospital for Children, Colombo

Objective: To assess the adherence of management of beta thalassaemia major patients at Lady Ridgeway Hospital to an established standard treatment protocol  Method: A clinical audit was carried out in all six medical wards of Lady Ridgeway Hospital from 1 st February 2008 to 31 st March 2008 with retrospective data collected over the period 1 st January 2005 to 31 st December 2007. The study population comprised all beta thalassaemia major patients admitted to the wards during the study period. Patients who did not give consent and those having other transfusion dependant anaemias were excluded from the study. The study instrument used was a pretested structured data collection form. Data collection was done by referring the past medical records. Data on ‘compliance’ was based on recall by the parent. Data analysis was done on a Microsoft Excel worksheet. Results: During the study period data was collected from 61 patients. Age at time of diagnosis ranged from 2 months to 5 years. All patients had their diagnosis confirmed by haemoglobin electrophoresis, high performance liquid chromatography or both tests. Pre-transfusion haemoglobin levels ranged from 4.1 mg/dl to 11.2 mg/dl. Number of blood transfusions per year ranged from 4–18 per year. Almost 50% of the patients had serum ferritin levels above the potentially cardiotoxic level of 2500 µg/l. Conclusions: Compliance of the patients with the treatment protocol was unsatisfactory. A high proportion of patients had cardiotoxic levels of serum ferritin. Sri Lanka Journal of Child Health , 2011; 40 : 48-53  (Key words: clinical audit; thalassaemia; blood transfusion; chelation; desferrioxamine; deferiprone; iron overload) doi: 10.4038/sljch.v40i2.3090