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Original article

Vol. 149 No. 2728 (2019)

Swiss Delphi study on iron deficiency

  • Albina Nowak
  • Anne Angelillo-Scherrer
  • Daniel Betticher
  • Michael Dickenmann
  • Idris Guessous
  • Pascal Juillerat
  • Wolfgang Korte
  • Stefan Neuner-Jehle
  • Otmar Pfister
  • Daniel Surbek
  • Edouard Battegay
  • Johann Steurer
DOI
https://doi.org/10.4414/smw.2019.20097
Cite this as:
Swiss Med Wkly. 2019;149:w20097
Published
03.07.2019

Summary

AIMS OF THE STUDY

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, and significantly affecting their quality of life. General practitioners (GPs) are frequently consulted with nonspecific symptoms due to the ID. However, little evidence is available to guide iron treatment. The aim of the Swiss Delphi study was to generate a broad consensual Swiss expert opinion in various therapeutic areas on diagnosis and treatment of ID/IDA and their practical implications.

METHODS

Specific statements regarding clinical relevance, practical diagnostic and therapeutic approaches, and treatment were evaluated by Swiss experts in various therapeutic areas using the Delphi method. “Consensus” was defined as ≥80% agreement; the agreement of 50–79% was defined as “critical”, of <50% as “disagreement”.

RESULTS

Consensus was reached for most statements. In patients without systemic inflammation, the threshold of 30 μg/l provide a good accuracy for the diagnosis of ID without anaemia. Ferritin levels within the range 30–50 μg/l with TSAT <20% can indicate ID without anaemia. Iron replacement therapy is accepted for treatment, not only of IDA, but also of symptomatic ID without anaemia. GPs play a central role in diagnosis and management of ID.

CONCLUSIONS

This consensus study provides potential therapeutic strategies for management of iron deficiency and is based on opinions of a high number of contributing specialists, providing their views from a wide range of clinical perspectives.

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