Evaluation of interventions to prevent vasovagal reactions among whole blood donors: rationale and design of a large cluster randomised trial

McMahon, A; Kaptoge, S; Walker, M; Mehenny, S; Gilchrist, PT; Sambrook, J; Akhtar, N; Sweeting, M; Wood, AM; Stirrups, K; Chung, R; Fahle, S; Johnson, E; Cullen, D; Godfrey, R; Duthie, S; Allen, L; Harvey, P; Berkson, M; Allen, E; Watkins, NA; Bradley, JR; Kingston, N; Miflin, G; Armitage, J; Roberts, DJ

Journal article

Evaluation of interventions to prevent vasovagal reactions among whole blood donors: rationale and design of a large cluster randomised trial

Abstract:: Abstract Background Vasovagal reactions (VVRs; faintness or fainting) can harm donor health and retention. Higher VVR rates are often observed in first-time donors and donors with VVR histories. We quantified associations between donation history (including donation experience, donation frequency, and VVR history) and VVR symptom reports in donors in England and assessed their mediation by venipuncture pain and donation anxiety. Methods In 60,026 STRIDES BioResource study participants recruited from 2019-2022, donation history was obtained from blood service records, while venipuncture pain, donation anxiety, and VVR symptoms were reported via post-donation questionnaires. We conducted causal mediation analyses estimating risk ratios (RRs) for indirect effects of donation history on VVR symptom reports through pain and anxiety while quantifying exposure-mediator interaction. Results Adjusted RRs for VVR symptoms were 1.24 (95% CI: 1.19, 1.30) for newer/lapsed donors, 1.19 (1.13, 1.25) for less frequent donors, and 1.82 (1.71, 1.94) for donors with VVR histories. Pain and anxiety were associated with up to 1.28 and 1.60 times the risk of symptom reporting. Anxiety mediated 19.0% and 11.2% of associations with donation experience and frequency, whereas pain mediated no associations. Associations of pain and anxiety with VVR symptoms were only observed among donors without, not with, VVR histories. Discussion Our findings suggest that differences in venipuncture pain and donation anxiety do not primarily explain differences in VVR symptoms by blood donation history. While intervening on pain and anxiety may fail to equalise symptom disparities linked to donation history, interventions may reduce VVR burden in donors without VVR histories

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

McMahon, A., Kaptoge, S., Walker, M., Mehenny, S., Gilchrist, P. T., Sambrook, J., Akhtar, N., Sweeting, M., Wood, A. M., Stirrups, K., Chung, R., Fahle, S., Johnson, E., Cullen, D., Godfrey, R., Duthie, S., Allen, L., Harvey, P., Berkson, M., … Roberts, D. J. (2023). Evaluation of interventions to prevent vasovagal reactions among whole blood donors: rationale and design of a large cluster randomised trial. Trials, 24(1), 512–512.

MLA Style

McMahon, A, et al. “Evaluation of Interventions to Prevent Vasovagal Reactions among Whole Blood Donors: Rationale and Design of a Large Cluster Randomised Trial.” Trials, vol. 24, no. 1, 2023, pp. 512–12.

Chicago Style

McMahon, A, S Kaptoge, M Walker, et al. 2023. “Evaluation of Interventions to Prevent Vasovagal Reactions among Whole Blood Donors: Rationale and Design of a Large Cluster Randomised Trial.” Trials 24 (1): 512–12.
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