Clinicians' Preferences and Perceptions of Iron Supplementation in the Treatment of Anemia in Indian Settings: Emphasis on Liposomal Iron Formulations

Abstract

Background: Iron deficiency anemia remains a major public health issue in India, necessitating effective supplementation strategies. Recent advancements, such as liposomal iron formulations, have garnered attention for their enhanced bioavailability and tolerability. This study aimed to assess clinicians' preferences and experiences with iron supplementation, focusing on liposomal iron in the Indian clinical setting. Methodology: A cross-sectional study was conducted among clinicians across India from June 2023 to December 2023 using a multiple-response questionnaire. Clinicians were asked to complete the questionnaire independently, and responses were analyzed using descriptive statistics, with results presented as percentages. Data visualization, including pie and bar charts, was performed using Microsoft Excel 2013. Results: The survey included 172 clinical experts and most clinicians (70%) preferred tablets for iron supplementation. A significant number (80%) of experts prescribed oral liposomal iron as their preferred formulation, citing its high bioavailability, ability to bypass restrictive intestinal barriers, and significantly higher plasma iron concentrations. Liposomal iron tablets were the most commonly used iron supplement among 79% of clinicians, reflecting advancements in formulations. Additionally, 39% of clinicians preferred oral liposomal iron in 26-50% of patients who experienced gastrointestinal side effects from other iron preparations, while 29% reported using it in less than 25% of such patients. A significant increase in hemoglobin levels with liposomal iron supplementation was noted by 61% of clinicians for both dialysis and non-dialysis patients. Furthermore, 51% found liposomal iron more tolerable than conventional preparations, with 57% rating its tolerability as excellent in their practice. Conclusion: The study revealed a clear preference among clinicians for oral liposomal iron supplementation due to its high bioavailability, improved tolerability, and effectiveness in raising hemoglobin levels, particularly in patients who experienced gastrointestinal side effects with other iron formulations. These findings suggest that liposomal iron is becoming a favored option in clinical practice for treating anemia in Indian settings.