Knowledge, attitude, and practice survey for patient blood management in India: An initiative by the special interest group of the Indian Society of Transfusion Medicine

Abstract: CONTEXT: Patient blood management (PBM) is an evidence-based, multidisciplinary approach to optimizing transfusion practices. Despite its inclusion in global health agendas, implementation in India remains fragmented. AIMS: The aim of the study was to assess the knowledge, attitude, and practice of healthcare professionals regarding PBM in India and to identify barriers to its clinical implementation. SETTINGS AND DESIGN: This was a cross-sectional, questionnaire-based online survey conducted nationwide under the aegis of the PBM special interest group of the Indian Society of Transfusion Medicine. SUBJECTS AND METHODS: A structured and validated 26-item questionnaire was disseminated among healthcare professionals. Responses were collected on key PBM “components” including clinical thresholds, anemia management, surgical planning, and postoperative strategies. STATISTICAL ANALYSIS USED: Descriptive statistics were applied. Internal consistency was measured using Cronbach’s alpha. Responses were categorized to highlight major trends and challenges. RESULTS: Out of 100 respondents, 78% were transfusion medicine specialists. While of respondents 97% acknowledged key predictors for transfusion decisions (e.g. hemoglobin, blood loss), 52% still preferred a liberal transfusion threshold of 10 g/dL, and 72% were willing to transfuse at ≥8 g/dL, which deviates from AABB guidelines. Major implementation barriers included stakeholder awareness gaps (55%), surgery delays due to PBM steps (42%), and perceived operation theatre underutilization (35%). Lack of time (73%) and test availability (69%) were less prominent challenges. CONCLUSIONS: There is a disconnect between PBM awareness and actual clinical practice in India. Advocacy, cross-specialty engagement, and regionally inclusive strategies are needed to enable evidence-based PBM adoption.