Anaemia is a common haematologic disorder which increasingly occurs in older age groups and its onset is usually insidious and slow . As anemia worsens and due to insufficient circulatory adaptive mechanisms in the elderly, discomfort and functional impairment may be progressively installed . Approximately, 11.0% of men and 10.2% of women ≥ 65 years are anaemic. One third of the elderly patients with anaemia present nutrient deficiencies, conditions which should be readily treated and cautiously linked with possible underlying disorders .
Symptoms reported in general practice/family medicine (GP/FM) play an important role in diagnosing anaemia. Fatigue, palpitations, dyspnoea on exertion, and poor concentration are some of the general symptoms related to anaemia, however they can be similarly linked with cancer, thyroid disorders, angina pectoris, and depression respectively [3–5]. Clinical signs like cheilitis, hair loss, fragility of nails and even cognitive impairment in many cases have been commonly associated with anaemia [1, 6–8]. Unexplained weight loss, insisting bony pain and other atypical signs deserve to be assessed so as to rule out malignancy or inflammation causes . Diagnosis of anaemia in primary care settings deserves attention and it is considered as essential task for GPs since it is frequently associated with chronic illness. The most common cause of iron deficiency anaemia (IDA) among those aged 50 and above is an occult loss of blood in the gastrointestinal (GI) tract . Premenopausal women also have a high prevalence of IDA not only secondary to menstrual blood loss but also due to low intake of dietary iron . Inadequate absorption of iron is another well established cause of IDA . The presence of IDA can also be the first sign of GI disorders including inflammatory bowel diseases, celiac disease and atrophic gastritis [12, 13]. Other known etiologies of IDA are intense physical exercise, chronic diseases which are paired with inflammatory processes, and the intake of agents that can subsequently interfere with the absorption of iron. In general, unless there is a clinically obvious cause, occult (GI) bleeding should always be considered, with studies demonstrating GI abnormalities in 62%-90% of patients [14, 15].
Although, the diagnosis of anaemia is considered as important in primary care, in a changing and uncertain world where the health care budgets are increasingly revisited, the need for an inexpensive and accurate diagnostic technology is becoming promising as option. Although the use of near-patient testing (point-of-care devices) is still a controversial issue introducing opposite views between clinical practitioners and laboratory physicians it attracts the interest of academic and laboratory researchers . It seems that the use of such diagnostic tools could lead to the identification of new cases of anaemia or other conditions, earlier than usually identified . In Greece, this seems to be rather neglected and there is limited information that reports the burden due to anaemia, and there are questions whether many cases have been undiagnosed with anaemia among patients visiting frequently rural primary care centers. It is also worthy to discuss to what extent inexpensive diagnostic tools can contribute to early diagnosis of anaemia. Towards this direction a multisetting study on anaemia diagnosis using a simple and low cost diagnostic tool was designed in rural Crete .
The primary focus of this cross-sectional study was to identify new cases of anaemia among patients in regular contact with their GP in rural Crete. A secondary focus was to explore the frequency of IDA among the new cases of anaemia.