Role of pain and anxiety in mediating relationships between donation history and vasovagal reaction symptoms in blood donors in England

Year: 2025

Type: article

Abstract: BACKGROUND: Vasovagal reactions (VVRs; faintness or fainting) can harm donor health and retention. Higher VVR rates are often observed in first-time donors and donors with VVR histories. We quantified associations between donation history (including donation experience, donation frequency, and VVR history) and VVR symptom reports in donors in England and assessed their mediation by venipuncture pain and donation anxiety. METHODS: In 60,026 STRIDES BioResource study participants recruited from 2019 to 2022, donation history was obtained from blood service records, while venipuncture pain, donation anxiety, and VVR symptoms were reported via post-donation questionnaires. We conducted causal mediation analyses estimating risk ratios (RRs) for indirect effects of donation history on VVR symptom reports through pain and anxiety while quantifying exposure-mediator interaction. RESULTS: Adjusted RRs for VVR symptoms were 1.24 (95% confidence interval: 1.19, 1.30) for newer/lapsed donors, 1.19 (1.13, 1.25) for less frequent donors, and 1.82 (1.71, 1.94) for donors with VVR histories. Pain and anxiety were associated with up to 1.28 and 1.60 times the risk of symptom reporting. Anxiety mediated 19.0% and 11.2% of associations with donation experience and frequency, whereas pain mediated no associations. Associations of pain and anxiety with VVR symptoms were only observed among donors without, not with, VVR histories. DISCUSSION: Our findings suggest that differences in venipuncture pain and donation anxiety do not primarily explain differences in VVR symptoms by blood donation history. While intervening on pain and anxiety may fail to equalize symptom disparities linked to donation history, interventions may reduce VVR burden in donors without VVR histories.

Source: Transfusion

DOI: 10.1111/trf.70004

Authors: Yaning Wu, Emanuele Di Angelantonio, Stephen Kaptoge, Angela M. Wood, Philippe T. Gilchrist, Matthew Walker, Nathalie Kingston, Barbara Masser, David Roberts, Eamonn Ferguson, Lois G. Kim

Institutions: University of Cambridge, National Institute for Health and Care Research, Human Technopole, Macquarie University, The University of Queensland, Australian Red Cross Lifeblood, National Health Service, John Radcliffe Hospital, University of Oxford, University of Nottingham

Language: English

Topic: Blood donation and transfusion practices

Subfield: Management of Technology and Innovation

Field: Business, Management and Accounting

Domain: Social Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,100

Funders: NHS Blood and Transplant, Wellcome Trust, Scottish Government, National Institute for Health and Care Research, British Heart Foundation, Department of Health and Social Care, University of Cambridge, Public Health Agency, Chief Scientist Office, Scottish Government Health and Social Care Directorate, NIHR BioResource, Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division, Health Data Research UK

OpenAlex ID: W4416460612