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Anemia as a Problem: GP Approach
Tamara Milovanovic1,2, Sanja Dragasevic1,2, Andreja Nebojsa Nikolic1
1Clinic for Gastroenterology and Hepatology, Clinical Center Serbia, Belgrade, Serbia.
Insights
Anemia, a common blood disorder, requires a thorough diagnostic approach in primary care. Evaluation involves patient history, physical exams, and specific lab tests to identify underlying causes.
Area of Science:
- Hematology
- Primary Care Medicine
- Clinical Practice
Background:
- Anemia is a global health issue, defined by low hemoglobin levels, often indicating underlying conditions.
- Hemoglobin levels vary by gender, ethnicity, and physiological state, and anemia can be multifactorial.
Purpose of the Study:
- To review and define the optimal diagnostic approach for anemia in primary care settings.
- To highlight the importance of a systematic evaluation for anemia diagnosis.
Main Methods:
- Review of clinical practice guidelines and literature.
- Emphasis on patient history and physical examination.
- Integration of laboratory findings, including complete blood count, reticulocyte count, peripheral smear, fecal occult blood test, and abdominal ultrasound.
Main Results:
- Common causes include nutritional deficiencies, medications, chronic diseases, malignancy, renal dysfunction, and bone marrow disorders.
- Diagnosis relies on hematological parameters, pathological mechanisms, and patient history.
- Primary care evaluation integrates clinical assessment with targeted laboratory and imaging studies.
Conclusions:
- A comprehensive diagnostic strategy for anemia in primary care is essential for effective management.
- The diagnostic pathway involves a combination of clinical evaluation, laboratory tests, and imaging.
- Variations in diagnostic practices may exist due to differing healthcare systems and physician education.
Background:
Anemia is a presentation of an underlying disease or deficiency. As stated by the WHO, anemia is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men. This review of clinical practice aimed to determine the diagnostic approach to anemia in primary care patients.
Summary:
Nutritional deficiencies, medications, chronic inflammatory conditions, malignancy, renal dysfunction, and bone marrow and inherent disorders contribute to anemia development. Anemia is classified and diagnosed by the values of hematological parameters, underlying pathological mechanism, and patient history. The diagnostic approach of anemia in primary care settings is focused on history, physical examination, laboratory findings including complete blood cell count, reticulocyte count, and peripheral smear examination, fecal occult blood test, and ultrasound findings.
Key Messages:
Anemia is the most common hematological disorder that represents a major health burden worldwide. Hb levels alter with gender, ethnicity, and physiological status. Anemia is often multifactorial. The evaluation of a patient with anemia in primary care includes clinical history, physical examination, and laboratory findings with fecal occult blood test and abdominal ultrasound. The wide variations in general practice in European countries are based on different health care systems but also knowledge of GPs that reflect educational and research policy.
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