BACKGROUND The study aimed to analyze anemia management in non-pregnant, and non-menopausal women aged from 18 to 50 years old, in a French primary care setting. METHODS An observational descriptive prospective study was conducted between November 2018 and February 2019. Inclusion criteria were as followed: anemia diagnosed in women aged from 18 to 50, not pregnant and not menopausal. Quantitative and qualitative data were anonymized and collected through an electronic survey. Investigating general practitioners completed the questionnaire for each newly diagnosed woman. Mean values and medians were calculated for the quantitative data. Answers to the open questions were encoded manually and proportions of the different modalities have been calculated. RESULTS Altogether, 43 women with anemia were ascertained. Moderate microcytic anemia, due to an iron deficiency in a context of menorrhagia, was the most observed anemia profile. The mean value of hemoglobin was 10.5 ± 1 g/dl. Among these women: 32 (74%) presented an iron deficiency, 17 (53%) had inappropriate intakes, and 9 (28%) reported menorrhagia. For 17 (40%) women, unnecessary or inappropriate exams were prescribed. The investigations did not allow to establish a differential diagnosis for 12 women (28%). Even for similar clinical situations, anemia management was variable. Among the women who presented iron deficiency, 15 (47%) were informed about an iron-rich diet and received a daily iron supplementation of ferrous sulfate between 80 mg and 160 mg. CONCLUSIONS Our study highlights that, in the absence of specific national guidelines for anemia management in non-pregnant, non-menopausal women in primary care settings, French GPs undergo various clinical management strategies leading to a heterogeneous, sometimes inappropriate follow-up. Women with iron deficiency were prescribed higher daily iron supplementation than recommended, according to new evidence, suggesting a maximal daily dose of 50 mg of elementary iron in a context of Hepcidin up-regulation in the case of an iron overload. Additional longitudinal studies with a bigger sample size and randomized controlled trials are needed to confirm our results and to elaborate national guidelines.

中文翻译：

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初级保健机构中非绝经期妇女的贫血管理：临床实践的前瞻性评估。


背景 该研究旨在分析法国初级保健机构中 18 至 50 岁非妊娠和非绝经女性的贫血管理情况。方法于2018年11月至2019年2月进行一项观察性描述性前瞻性研究。纳入标准如下：18岁至50岁、未怀孕且未绝经的女性中诊断出贫血。定量和定性数据是匿名的，并通过电子调查收集。调查全科医生为每位新诊断的女性填写了调查问卷。计算定量数据的平均值和中位数。对开放问题的答案进行了手动编码，并计算了不同模式的比例。结果 总共确定了 43 名患有贫血的女性。由于月经过多而缺铁所致的中度小细胞性贫血是最常见的贫血特征。血红蛋白的平均值为 10.5 ± 1 g/dl。在这些女性中：32 名 (74%) 存在铁缺乏症，17 名 (53%) 存在铁摄入不当，9 名 (28%) 存在月经过多。对于 17 名 (40%) 女性，进行了不必要或不适当的检查。调查未能对 12 名女性 (28%) 进行鉴别诊断。即使对于类似的临床情况，贫血管理也是可变的。在缺铁的女性中，有 15 名（47%）被告知富含铁的饮食，并每天补充 80 毫克至 160 毫克的硫酸亚铁。 结论 我们的研究强调，由于缺乏针对初级保健机构中非怀孕、非绝经妇女贫血管理的具体国家指南，法国全科医生采用了各种临床管理策略，导致了异质性、有时不适当的随访。根据新的证据，缺铁的女性每天需要补充的铁量高于建议的量，这表明在铁过载的情况下，铁调素上调的情况下，每日最大剂量为 50 毫克元素铁。需要更大样本量的额外纵向研究和随机对照试验来证实我们的结果并制定国家指南。