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We are contacting you to request your participation in a study aimed at gaining insights into anemia management in survivors of critical illness. 1. Research Title and Ethics Committee Approval The title of this survey is "Attitudes of medical doctors and pharmacists towards the pharmacological management of anemia in critically ill patients". This research has been reviewed by the Epidemiological Research Ethics Committee of Hiroshima University and approved by the Director of Hiroshima University. 2. Research Collaborating Institutions and Principal Investigator This survey is being conducted with the collaboration of Dr. Yuki Kataoka (Nagoya University), Dr. Richard Bourne (University of Manchester), Dr. Cathrine McKenzie (University of Southampton), Dr. Kent Doi (The University of Tokyo Hospital), Dr. Simon Oczkowski and Dr. Joanna Dionne (McMaster University), and Dr. Alexander Vlaar (Amsterdam University Medical Centers). 3. Research Purpose and Significance The purpose of this study is to explore the knowledge, attitudes, and clinical practices of medical doctors and pharmacists regarding the pharmacological management of anemia in critically ill patients. Anemia is a frequent condition in Intensive Care Unit (ICU) patients, often persisting after discharge and leading to various complications such as readmission and mortality. Although “Erythropoiesis-stimulating agents (ESA) and Hypoxia-inducible factor prolyl-4-hydroxylase inhibitors (HIF-PHI)” has been proposed, their clinical adoption remains limited due to uncertainty including unclear patient selection criteria. Therefore, by identifying current clinical perspectives and practices, this survey aims to clearly barriers to implementation and contribute to the development of more effective and evidence-informed anemia management strategies in the ICU setting. 4. Research Method and Period This study is a scenario-based questionnaire survey. The research period is from the date of ethics approval to December 31, 2026. The response period for the questionnaire is set at six months from the initial survey recruitment email. This survey takes approximately 20 minutes to complete. The information obtained will be used only for research purposes and be shared and analyzed with Nagoya University. 5. Reason for Selection as Research Subjects This study targets medical doctors or pharmacists who have experience managing or have managed critically ill patients (excluding post-operative patients) admitted to the ICU. The medical doctors and pharmacist members of these societies match the criteria of the research. 6. Burdens, Anticipated Risks, and Benefits for Research Subjects Burden: Approximately 15 minutes required to complete the questionnaire. Risk: Possibility of personal information leakage if email addresses contain personal information. As a countermeasure, email addresses will be immediately deleted during data compilation. Benefit: While there are no direct benefits, participants can contribute to improving pharmacological treatments of anemia in critically ill patients. 7. Consent and Withdrawal By responding to the questionnaire, you are considered to have consented to participate in this study. Consent can be withdrawn even after responding, as long as it's before data compilation. There are no disadvantages for not consenting or withdrawing consent. 8. Method of Disclosing Research Information The results of this study will be made public through paper submissions and conference presentations. 9. Method of Obtaining/Viewing Research Protocol The research protocol and materials related to research methods can be obtained or viewed to the extent that it does not compromise personal information protection and research originality. If you wish to do so, please contact us using the contact information below. 10. Handling of Personal Information Collected information will be processed and analyzed in a form that cannot identify individuals. 11. Storage and Disposal of Information Collected information will be stored for 5 years after the end of the research and then appropriately disposed of. 12. Research Funding Source and Conflicts of Interest This research is conducted with the university's operational grants, and the researchers have no conflicts of interest. 13. Handling of Research Results Research results will be anonymized and statistically analyzed. Individual results will not be disclosed. 14. Response to Inquiries Questions and inquiries about the research will be addressed at the following contact. Details of the research plan are published at the following link: https://osf.io/6b94z/ Sincerely, Shodai Yoshihiro, Mitsuaki Nishikimi, Nobuaki Shime, Hiroaki Matsuo Hiroshima University Hospital shodaidotet@gmail.com

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ESICM surveys assess clinical research impact, improving patient care. Open surveys target ICU professionals globally.

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