Symposium 12 - Patient Blood Management and Women’s Health

Approximately three billion individuals worldwide suffer from iron deficiency and anaemia, while an additional 600 million experience acute or chronic blood loss and/or bleeding disorders. These conditions are significant contributors to morbidity, mortality, and healthcare resource utilization. Moreover, they adversely affect cognitive development, quality of life, and productivity. For decades, the scale and severity of this global health challenge have been largely unrecognized by the medical establishment. One contributing factor is the traditional perception of blood as an organ yet as an easily replaceable commodity, routinely replenished by voluntary blood donors. However, accumulating evidence underscores the importance of etiology-specific management of anaemia, blood loss, and coagulopathy, demonstrating that targeted interventions can substantially improve patient outcomes, reduce healthcare costs, and as a corollary largely avoid blood transfusions.1 The result of this paradigm shift is described as Patient Blood Management (PBM), a comprehensive, evidence-based model of care that prioritizes the optimization of a patient's own blood.2 The overarching goal of PBM is to achieve blood health, defined as the optimal function of individual blood components and their interactions with other organs and physiological systems.3 Recognizing the importance of this approach, the World Health Organization (WHO) has called upon its member states to rapidly implement PBM as a standard of care. To support this initiative, the WHO has introduced its Guidance on Implementing Patient Blood Management to Improve Global Blood Health Status, which provides a strategic framework for Ministries and Departments of Health worldwide.4 This guidance aims to facilitate the integration of PBM into healthcare systems through collaboration with local health organizations, hospitals, and medical centers.

Background
The Thematic Report on Iron Status (Population Health Survey (PHS) 2020-22) conducted by the Department of Health (DH) which presents the iron status of the general population of Hong Kong revealed that women of reproductive age (aged 15 to 49) have a higher prevalence of iron deficiency (ID) than men and women of post-menopausal age (aged 50 to 84). The prevalence of ID in the local population aged 15 to 84 (including women of reproductive age) was about 5.7% and that for women of reproductive age (aged 15 to 49) was 17.5%. According to WHO's latest guideline in 2020, this is classified as a "mild magnitude of public health problem". The prevalence of iron deficiency anaemia (IDA) was higher in women (6.4%) than men (0.3%) and was higher in women of reproductive age (10.6%) than women of post-menopausal age (2.1%). The local findings of a higher prevalence of ID and IDA among women of reproductive age are similar to that of relevant studies in high income countries, and are believed to be due to their regular and heavy menstrual blood loss. 


Public Health Strategy
To follow up on the iron status of the local population, the DH set up the Working Group on Prevention of Iron Deficiency, comprising experts from the different medical disciplines in Hong Kong. The Working Group has reviewed the latest scientific evidence and formulated the Joint Recommendations on Iron Intake for Public Particularly for Women of Reproductive Age (Joint Recommendations). 


This presentation will provide the overview of iron status of the local population, the Joint Recommendations and the multi-pronged approach of promulgating adequate iron intake to the public and the community, and to solicit support from healthcare professionals to join hand in advising their clients. DH will conduct regular surveys for continuous surveillance on iron status and the recommendations will be reviewed in light of research findings in future.