Use of platelets and the challenge of adherence to guidelines: Who, when and why?

Effective implementation of evidence-based platelet transfusion guidelines would be expected to reduce adverse events, improve platelet availability and decrease costs, all without increasing risk for mortality or bleeding. For this reason, leveraging existing data to evaluate transfusion practices is important, but little is known about how best to approach this across a hospital or health system considering, for example, clinical context. The study by Ryan and colleagues reports an approach to evaluate platelet guideline adherence using health science data from a multicentre Canadian database. The findings highlight practice variation, use of platelets outside evidence-based recommendations in guidelines and identify multiple pressing opportunities for quality improvement research. Commentary on: Ryan et al. Opportunities for improving platelet transfusion practice: A large retrospective audit across 22 hospitals. Br J Haematol 2026; 208:670-682.