1402 TRANSFUSION Volume 46, August 2006 Blackwell Publishing IncMalden, USATRFTransfusion0041-11322006 American Association of Blood BanksAugust 200646814021407Original Article ACCURACY OF BLOOD DONOR HISTORYMELANSON ET AL. From the Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School; and the Division of Laboratory Medicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Address reprint requests to: Kent B. Lewandrowski, Division of Laboratory Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ 5, Boston, MA 02114; e-mail: klewandrowski@ partners.org. Received for publication October 20, 2005; revision received January 9, 2006, and accepted January 9, 2006. doi: 10.1111/j.1537-2995.2006.00909.x TRANSFUSION 2006;46:1402-1407. BLOOD DONORS AND BLOOD COLLECTION Does blood donor history accurately reflect the use of prescription medications? A comparison of donor history and serum toxicologic analysis Stacy E.F. Melanson, Christopher P. Stowell, James G. Flood, Elizabeth Lee Lewandrowski, Rychard J. Zak, and Kent B. Lewandrowski BACKGROUND: Blood donor screening is performed to accomplish several goals, including donor safety during collection and recipient safety during transfusion. Donors taking certain medications such as teratogens or platelet- inhibiting drugs are deferred from donation. Studies investigating the accuracy of the donor history are limited and only provide data on select groups of drugs. This study compares the results of an extended serum toxicology analysis to the medication use reported on the donor questionnaire. STUDY DESIGN AND METHODS: Whole-blood samples were collected from 108 volunteer blood donors. A serum toxicology analysis was performed with high- performance liquid chromatography with photodiode array detection. The results were compared to those reported on the donor history questionnaire. RESULTS: The medication history was consistent with the reported medications in 96 (89%) donors. Serum toxicology testing detected medications that were not reported on the donor history form in 12 (11%) donors. Most of the donors who did not accurately report their medication use (8 or 67%) were taking psychotropic medications. CONCLUSION: Eleven percent of the donors did not fully disclose their recent medication history. Although none of the omitted medications would have been grounds for deferral, the finding of underreporting questions the reliability of donor screening. Despite a negative medication history, blood donor centers cannot assume that donors are medication-free. This study reveals a bias to omit psychotropic medications such as antidepressants and anxiolytics. lood donors are screened for the use of medica- tions and intravenously administered illicit drugs to several ends. The use of intravenously administered illicit drugs is highly correlated with infection with parenterally transmitted diseases such as the hepatitis B and C viruses and the human immuno- deficiency viruses. 1-3 It may also be associated with other high-risk behaviors, such as sexual contact with other infected individuals or the barter of sexual services for the drugs themselves. 4-8 The deferral of donors with a history of the illicit use of intravenous (IV ) drugs has been imple- mented to reduce the likelihood of infectious disease transmission to recipients. Blood donors are also questioned about use of pre- scription medications. This questioning accomplishes two goals. The use of a prescription medication may indi- cate to the interviewer that the prospective donor has a medical problem that may, independently, constitute a reason for deferral, either because the person might be put at risk by donation (e.g., anemia, coronary artery insufficiency) or because the blood might pose a hazard to the recipient (e.g., bacterial infection). The other goal is to identify donors taking medications that either affect the quality of the blood components (e.g., aspirin) or could pose a hazard, at least to susceptible transfusion recipi- ents (e.g., teratogens). Donors in the United States are B