Research concepts and methodologies

¶ … administering pre-transfusion medications as a means of preventing post-transfusion reactions, examining the literature for support of current practices and for alternative practices that might prove more beneficial. In the initial phase of this project, the problem that was identified was not specifically an abundance of post-transfusion reactions, but rather the administering of medicines -- specifically acetaminophen and diphenhydramine -- as a prophylactic treatment meant to prevent post-transfusion reaction despite a lack of empirical evidence that this practice actually worked. A single article concerning the fact that these medications remain commonly prescribed as pre-transfusion prophylactics without real evidence supporting this practice, and that a possibly more effective pharmaceutical prophylactic existed, served as the spark for instigating this project, and spurred further investigation.

After the problem and a potential solution was identified, a specific research question was developed in order to guide a more extensive investigation. The population of patients being studied was identified as those receiving blood transfusions in hospital settings, with the intervention proposed being antipyretic medications. The comparison that this intervention was placed against in this research question was the current standard practice of prescribing acetaminophen and diphenhydramine, with the desired outcome being the reduction of post-transfusion reactions in terms of both their severity and the rate at which they occurred. With these parameters of the research question defined, the project could progress.

The next step of the project was conducting a more extensive literature review, and from this review it became quite clear that there was little to no empirical basis for the prescribing of diphenhydramine and/or acetaminophen as a means of preventing post-transfusion infections. This literature review revealed that this practice had begun in the 1950s, and was an outgrowth of less-than-reliable studies that were accepted at the time but that are questionable now in terms of their methodologies and scope. The fact that no substantive studies conducted in more recent years have been able to substantiate the findings of these half-century-old studies is a strong indicator that the practices recommended by the earlier studies are not necessarily effective and could potentially be harmful.