Please cite this article in press as: Duarte GC, et al. Implementation of a patient blood management program based on a low-income country- adapted clinical decision support system. Hematol Transfus Cell Ther. 2021. https://doi.org/10.1016/j.htct.2020.12.010 ARTICLE IN PRESS HTCT-3252; No. of Pages 5 hematol transfus cell ther. 2 0 2 1; x x x(x x) :xxx–xxx www.htct.com.br Hematology, Transfusion and Cell Therapy Original article Implementation of a patient blood management program based on a low-income country-adapted clinical decision support system Gustavo de Carvalho Duarte a,b,* , Francisco Guilherme Fujita Neto a,b , José Francisco Comenalli Marques Júnior a , Dante Mario Langhi a a H. Hemo Hemoterapia Brasil SA, São Paulo, SP, Brazil b Fujisan, Fortaleza, CE, Brazil a r t i c l e i n f o Article history: Received 27 July 2020 Accepted 8 December 2020 Available online xxx Keywords: Transfusion medicine Blood transfusion Transfusion reaction Patient care management Medical audit a b s t r a c t Introduction: Patient blood management (PBM) programs are associated with better patient outcomes, a reduced number of transfusions and cost-savings The Clinical Decision Support (CDS) systems are valuable tools in this process, but their availability is limited in developing countries This study assesses the feasibility and effectiveness of an adapted CDS system for low-income countries. Methods: This was a prospective study of the PBM program implementation, in a 200-bed tertiary hospital, between February 2019 and May 2020. Outcome measures were red blood cell (RBC), fresh frozen plasma (FFP) and platelet unit transfusions, the transfusion of a single unit of red blood cells and an RBC adequacy index (RAI). Results: Comparing the post-PBM program era with the pre-PBM system era, there was a decrease in red blood cell transfusions (p = 0.05), with an increase in single unit red blood cell transfusions (p = 0.005) and RAI (p < 0.001). Conclusions: The PBM programs, including electronic transfusion guidelines with pre- transfusion medical auditing, was associated with improved transfusion practices and reduced product acquisition-related costs. © 2021 Associac ¸˜ ao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Introduction The blood transfusion is a very useful tool in the management of a wide spectrum of diseases, being performed in approxi- * Corresponding author at: Avenida Pacaembu, 1273, São Paulo CEP: 01234-000, Brazil. E-mail address: gustavo.duarte@hhemo.com.br (G.C. Duarte). mately 10–15% of all hospitalizations worldwide. 1 Although a lot of improvements have been achieved over the last decades, transfusions are still associated with inexorable risks. In addi- tion, several studies have shown that this tool is frequently https://doi.org/10.1016/j.htct.2020.12.010 2531-1379/© 2021 Associac ¸˜ ao Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).