Swiss Delphi Study on Iron Deficiency

<b>Objectives</b>Iron deficiency (ID) and iron deficiency anaemia (IDA) are important conditions affecting a large proportion of the general population, causing the patients` physical and psychosomatic symptoms, particularly fatigue, significantly affecting their quality of life. In pregnancy, ID and IDA may affect the foetus and the new-born child, and may lead to pregnancy complications. Unspecific symptoms due to ID are frequently encountered in General practice, however, little evidence is available to guide iron substitution. As a consequence, misuse of iron replacement therapy has been reported. <br><b>Design</b>We conducted a <i>Swiss Delphi Study </i><i>on Iron Deficiency </i>in order<i> </i>to generate a broad consensual Swiss expert opinion in various therapeutic areas on diagnosis and treatment of ID/IDA and their practical implications. <br><b>Setting</b>Specific statements regarding clinical relevance, practical diagnostic and therapeutic approaches, and treatment have been evaluated by Swiss experts in various therapeutic areas. <br><b>Participants </b>Expert panel.<br><b>Intervention</b>Online anonymous surveys containing overall 440 statements. <br><b>Outcome measures</b>Percentage of Consensus, Critical Consensus and Disagreement for each statement. <b>Results </b>Consensus (&gt;80% agreement) was achieved for 50% (N=218), Critical Consensus (agreement of 50-79%) for further 39% (N=173) and Disagreement for 11% (N=49) (agreement&lt;50%) of the statements. In patients without systemic inflammation, the threshold of 30 μg/L for serum ferritin provides a good accuracy for the diagnosis of ID without anaemia. Additionally, ferritin levels within the range of 30-50 μg/L with transferrin saturation (TSAT)&lt;20% can indicate ID without anaemia. Iron replacement therapy is accepted for treatment, not only of IDA, but also of symptomatic ID without anaemia. Finally, GPs play a central role in diagnosis and management of ID.<br><b>Conclusion</b> This consensus study, based on opinions of a high number of contributing specialists, provides potential therapeutic strategies for management of iron deficiency in a wide range of clinical perspectives. <br>