Understanding donation frequency: insights from current plasma donors.

BACKGROUND AND OBJECTIVES: Encouraging existing plasma donors to donate more frequently is a key objective for blood donation services committed to expanding yield through voluntary non-remunerated plasmapheresis donation. This requires an understanding of donors' perspectives on their current donation practice and how this relates to their knowledge and beliefs about the need for plasma. To explore this, Australian plasma donors were interviewed about how they arrived at the frequency at which they donate. MATERIALS AND METHODS: Semi-structured telephone interviews were conducted with 105 Australian plasmapheresis donors. RESULTS: Key themes identified were as follows: fitting donation into busy lives and how ideas about being an ongoing donor and the institutional context shaped their perspective on frequency; perceptions of the impact of donation on health; and wanting to make a greater contribution. CONCLUSION: Experienced plasma donors work to maintain a donation practice in the context of busy lives often by adopting a flexible approach to donation frequency. Their knowledge of the contribution their donations make is key to their continued donation, yet most identified constraints to donating more frequently. Health concerns were a particular concern for some, and more research is needed to understand donors' perspectives on the impact of donating on their health.

Building a flexible, voluntary donation panel: an exploration of donor willingness.

BACKGROUND: As blood collection agencies (BCAs) face recurrent shortages of varying blood products, developing a panel comprising donors who are flexible in the product they donate based on same-time inventory demand could be an efficient, cost-effective inventory management strategy. Accounting for prior whole blood (WB) and plasmapheresis donation experience, this article explores current donors' willingness to change their donation product and identifies the type of information required for such donation flexibility. STUDY DESIGN AND METHODS: Telephone interviews (mean, 34 min; SD, 11 min) were conducted with 60 donors recruited via stratified purposive sampling representing six donor groups: no plasma, new to both WB and plasma, new to plasma, plasma, flexible (i.e., alternating between WB and plasma), and maximum (i.e., high frequency alternating between WB and plasma) donors. Participants responded to hypothetical scenarios and open-ended questions relating to their and other donors' willingness to be flexible. Responses were transcribed and content was analyzed. RESULTS: The most frequently endorsed categories varied between donor groups with more prominent differences emerging between the information and support that donors desired for themselves versus that for others. Most donors were willing to change donations but sought improved donation logistics and information regarding inventory levels to encourage flexibility. The factors perceived to facilitate the flexibility of other donors included providing donor-specific information and information regarding different donation types. CONCLUSION: Regardless of donation history, donors are willing to be flexible with their donations. To foster a flexible donor panel, BCAs should continue to streamline the donation process and provide information relevant to donors' experience.

A novel approach to increasing inventory with the current panel: increasing donation frequency by asking for a different blood product.

BACKGROUND: Ongoing shortages of blood products may be addressed through additional donations. However, donation frequency rates are typically lower than medically possible. This preliminary study aims to determine voluntary nonremunerated whole blood (WB) and plasmapheresis donors' willingness, and subsequent facilitators and barriers, to make additional donations of a different type. STUDY DESIGN AND METHODS: Forty individual telephone interviews were conducted posing two additional donation pattern scenarios: first, making a single and, second, making multiple plasmapheresis donations between WB donations. Stratified purposive sampling was conducted for four samples varying in donation experience: no-plasma, new-to-both-WB-and-plasma, new-to-plasma, and plasma donors. Interviews were analyzed yielding excellent (κ values > 0.81) inter-rater reliability. RESULTS: Facilitators were more endorsed than barriers for a single but not multiple plasmapheresis donation. More new-to-both donors (n = 5) were willing to make multiple plasma donations between WB donations than others (n = 1 each) and identified fewer barriers (n = 3) than those more experienced in donation (n = 8 no plasma, n = 10 new to both, n = 11 plasma). Donors in the plasma sample were concerned about the subsequent reduced time between plasma donations by adding WB donations (n = 3). The no-plasma and new-to-plasma donors were concerned about the time commitment required (n = 3). CONCLUSION: Current donors are willing to add different product donations but donation history influences their willingness to change. Early introduction of multiple donation types, variation in inventory levels, and addressing barriers will provide blood collection agencies with a novel and cost-effective inventory management strategy.

Changes in quality of life scores with intravenous immunoglobulin or plasmapheresis in patients with myasthenia gravis.

BACKGROUND: Intravenous immunoglobulin (IVIG) and plasmapheresis (plasma exchange (PLEX)) have comparable efficacy in reducing the Quantitative Myasthenia Gravis Score for disease severity (QMGS) in patients with moderate to severe myasthenia gravis (MG). OBJECTIVE: To determine if the improvement in the quality of life (QOL) after immunomodulation is comparable with either IVIG or PLEX. METHODS: 62 patients participated in the MG-QOL-60 study, completing the questionnaire at baseline and at day 14 after treatment. The MG-QOL-15 scores were computed from the MG-QOL-60 questionnaire responses. We analysed the change in the QOL scores from baseline to day 14 in both treatment groups. RESULTS: The scores in both QOL scales decreased at day 14 in the IVIG and PLEX groups, without significant difference between groups (QOL-15: IVIG -5.7 ± 8.5, PLEX: -7.0 ± 7.6, p=0.52; QOL-60: IVIG -13.3 ± 16.9, PLEX -18.5 ± 22.0, p = 0.41). The improvement in QOL showed a good correlation with the decrease in QMGS. There was an excellent correlation between the MG-QOL-15 and MG-QOL-60 scores at baseline and at day 14. CONCLUSIONS: This study of MG-QOL changes supports recent findings that IVIG and PLEX are comparable in the treatment of patients with moderate to severe MG and worsening symptoms. Furthermore, our study supports the use of the MG-QOL-15 as a secondary outcome measure in future clinical trials in MG.

Perceived deterrents to being a plasmapheresis donor in a voluntary, nonremunerated environment.

BACKGROUND: As demand for plasma-derived products increases internationally, maintaining a committed plasmapheresis panel membership is critical for blood collection agencies. This study addresses the current lack of knowledge regarding deterrents to the recruitment and retention of plasmapheresis donors in a voluntary nonremunerated environment. STUDY DESIGN AND METHODS: Nine focus groups (n = 84) and six individual interviews were conducted using semistructured schedules. Three focus groups were conducted with each category of eligible whole blood (WB) donors: those who had 1) declined to convert to plasmapheresis (DTC), 2) converted but lapsed to WB (LWB), and 3) converted and lapsed from the panel completely (LFP). Transcript analysis revealed distinct deterrent categories. RESULTS: The time required for plasmapheresis was a universally identified deterrent, with concerns of donation frequency expectations shared between DTC and LWB. LWB and LFP both reported excessive questioning and paperwork, and eligibility requirements as deterrents. Unique deterrents for DTC were a lack of accurate knowledge about safety and process. LWB reported concerns about plasmapheresis donation outcomes; however, they were more committed to continuing donation than LFP, who reported donation not being salient, being too busy, and poorer donation experiences. CONCLUSION: Providing information to address safety and health concerns should be the focus for successful conversion to plasmapheresis. Setting donation frequency expectations at levels to which donors are accustomed may improve evaluations of the cost/benefit ratio of conversion and retention. Involvement levels (i.e., importance, personal meaning of donation) may be the key differentiator between those donors who return to WB and those that lapse altogether.

Determinants of plasma donation: A review of the literature.

The major contribution of Human Sciences in the understanding of the whole blood donation behavior has been through the study of individuals' motivations and deterrents to donate. However, if whole blood donation has been very widely studied in the last sixty years, we still know very little about plasma donation in voluntary non-remunerated environments. Yet, the need for plasma-derived products has been strongly increasing for some years, and blood collection agencies have to adapt if they want to meet this demand. This article aims to review the main motivations and deterrents to whole blood donation, and to compare them with those that we already know concerning plasma donation. Current evidence shows similarities between both behaviors, but also differences that indicate a need for further research regarding plasma donation.

[Commitment in plasmapheresis donation: A study of determinants among regular donors in plasmapheresis]. / L'engagement dans le don de plasma : étude des déterminants chez des donneurs réguliers en plasmaphérèse.

The purpose of this study, based on the Theory of planned behavior, is to identify and ultimately better understand what determines the fidelity and the regularity of donors committed in plasmapheresis donation. This qualitative study is a primary stage to establish a classification of donors in a French socio-cultural context. For this reason, we have carried out a survey among 16 regular plasmapheresis donors, by way of semi-structured individual interviews at the Établissement français du sang - Brittany. The level of commitment of these regular donors is considered as a level of appropriation. If subjective norms have initially influenced their decision to donate blood, no specific motivation has been highlighted for them to donate plasma except a generally favourable attitude towards the voluntary donation process. The perception of control over their environment is a variable which played a decisive role in the donor's intention to give, with little cost associated to plasmapheresis donation and recourse to internal causal explanations. A better comprehension of the plasmapheresis donors' determinants should lead us to a more efficient awareness of new potential donors, thereby enhancing recruitment and retention. Due to the increasing need for plasma-derived products, this study's ultimate issue is closely correlated both with ethical and socio-economic aspects. Following which, after analysing the results, a certain number of recommendations will be made.

[Ethics, motivations of plasmapheresis donors]. / Ethiques, motivations des donneurs d'aphérèse plasmatique.

For 50 years, the French Blood Transfusion Service has been developing ethical concepts of anonymous, voluntary and non-profit donation. The subject of this work is the study of ethical aspects and motivations of plasmapheresis donors. Three hundred donors were questioned on these subjects. The questionnaire was created after analysing the semi-orientated interviews of ten donors. The donors are male, aged over 35, with relatively high social and professional backgrounds. The main reason given for the first donation is the request by a relative or another person. With regards to further donations, solidarity with patients is mentioned as a reason. Even if the majority of the donors are aware of the ethical aspects of donation, over 50% of them accept to give plasmapheresis regardless of these principles. Plasmapheresis donors are primarily motivated by solidarity reasons. Thereby, they are fully active in the evolution of society.

Why do some apheresis donors donate blood just once?

BACKGROUND AND OBJECTIVES: More knowledge about the reasons for non-return of blood donors (BD) would enable blood donation services (BDS) to improve the efficacy of recruitment and retention programmes. We interviewed returning (RBD) and non-returning apheresis BDs (NRBD) of our university hospital-based BDS. MATERIALS AND METHODS: A questionnaire was sent to 1218 individuals who passed the initial health check with no more than one subsequent blood donation. A similar questionnaire was answered by 235 randomly incoming RBDs. We asked for age, sex, profession, education level, motives to donate blood and, if applicable, reasons for non-return. These data were compared between NRBDs and RBDs and were analysed in relationship to the reasons for non-return. RESULTS: We received 267 answered questionnaires (21.9%). As 32 individuals indicated that they had been permanently deferred and 47 BDs had donated blood elsewhere, 188 NRBDs remained for further analysis. We found more women than men among NRBDs. Medical professions were less likely to return than students and trainees. Individuals motivated by personal experience, remuneration or a free health check were more likely to return than others. Whereas logistic reasons were of highest relevance for non-return in general, women indicated anxiety of blood donation as reason for non-return more often than men. CONCLUSION: Reducing women's anxiety of blood donation, reminding medical professions more intensively on blood donation and appealing to personal experience or a free health check may be the most promising approaches to increase BDs' return rates.