Subthemes present in the final three patient interviews	N of patients reporting data to these subthemes	Participants 12–14 (X indicates participant contributed to this theme)			Final patients reporting data to subtheme
	(interviews 1–11)	12	13	14
Patients
Awareness of risk/safety (3 of 5 subthemes)
Discomfort and illness during or post‐transfusion	5	X		X	7
Health risks from high iron levels	2	X	X		4
Potential infection or reaction risk	4			X	5
Health benefits (5 of 6 subthemes)
Boosting blood levels	6		X	X	8
Keep going with daily life	5	X	X		7
Relief of symptoms such as tiredness	6	X			7
Anticipated benefits	4		X	X	6
Can take time to feel benefit of transfusion	1		X		2
	(interviews 1–11)	12	13	14
Negative emotions (6 of 8 subthemes)
No concerns or worries with transfusions	8		X	X	10
Attempts to manage worries and fear	6	X	X	X	9
Gratitude that transfusions possible	3	X		X	5
Relaxed during transfusion appointments	4			X	5
Receiving transfusions unpleasant	3	X			4
Positive emotions of not needing transfusion	1	X			2
Alternatives (1 of 4 subthemes)
Alternatives considered or already in use	5	X		X	7
Necessity (3 of 5 subthemes)
Transfusions required as a current and long‐term supportive treatment	7	X	X	X	10
Need established by HCPs and clinical indicators	7	X			8
Need for transfusion apparent through symptoms	6	X	X		8
	(interviews 1–11)	12	13	14
Involvement in decision making (5 of 7 subthemes)
Willing acceptance of transfusions	6	X			7
Confronted with limited or no choice	5		X		6
Transfusion offered with patient involvement in choice	4	X	X	X	7
Routine ‘automatic’ treatment	2			X	3
More frequent transfusions would be resisted	1	X			2
Burden (4 of 4 subthemes)
Transfusion part of routine life	5		X	X	7
Transfusions are inconvenient	4	X			5
Attendance not a great burden	3		X		4
Life restrictions, travel	2	X	X		4
Social connection (3 of 5 subthemes)
Patient involvement generally positive	4	X		X	6
	(interviews 1–11)	12	13	14
Lack of interaction or activity during transfusions	4			X	5
Interaction with other patients	4	X	X		6
HCPS
Awareness of risk/safety (6 of 6 subthemes)
Risks mitigated by safe transfusion practices	9	X	X	X	12
Risks and benefits established with patients	7	X		X	9
Iron overload considered a key risk	5	X	X		7
Infections, antibodies and reactions risks	6			X	7
Short and long‐term medical and psychological impact	4	X	X		6
Risk of not providing a transfusion	2	X	X	X	5
Alternatives (4 of 4 subthemes)
Alternatives considered or already in use	8		X	X	10
	(interviews 1–11)	12	13	14
No alternatives, transfusion the only option	5		X	X	7
Support for greater consideration and use of alternatives	4		X	X	6
Committed to giving regular transfusions once started	2		X		3
Burden (2 of 2 subthemes)
Anticipated attendance burden for patients	9	X		X	11
Transfusion has become a part of patient's routine life	5		X	X	7
Health benefits (6 of 6 subthemes)
Symptom improvement, making patients feel better	9	X	X		11
Supportive care to carry on with normal daily living	9		X		10
Benefit lasts a limited time only	7		X		8
Shared HCP agreement of transfusion benefits	4			X	5
	(interviews 1–11)	12	13	14
Patient questioned on benefits to provide / continue transfusions	4		X		5
Some risk‐benefit for patients questionable	2		X		3
Necessity (4 of 5 subthemes)
Transfusions support chemotherapy or used to treat anaemia	9	X	X	X	12
Transfusions are vital, aiding survival	8		X	X	10
Transfusions given to protect health	7		X		8
Necessity established using clinical and patient factors	7			X	8
Negative emotions (5 of 7 subthemes)
Practice concerns and frustrations	9			X	10
Patient anxiety and upset with receiving regular transfusions	8	X	X		10
	(interviews 1–11)	12	13	14
Concern about downsides of transfusions for patients	8	X	X		10
Patients’ unexpressed potential negative emotions	7	X	X		9
Upset in witnessing patients’ worsening health or death	2			X	3
Involvement in decision making (6 of 8 subthemes)
HCPs advocate and involve patients in decisions	10	X	X	X	13
Team decision on transfusion prescription	12			X	13
Patient autonomy in their own transfusion decisions	9	X	X		11
Individual transfusion regime for each patient	8		X	X	10
Transfusions prescribed appropriately using guidelines	5	X	X	X	8
Barriers to discussing transfusion or obtaining consent	3		X	X	5
	(interviews 1–11)	12	13	14
Organisational factors (5 of 5 subthemes)
Solutions needed to improve processes and ease capacity strain	6		X		7
Solutions needed to enhance communication	5		X		6
High and costly blood use for hospital	5	X			6
Constraints to greater discussion of patients’ views	5		X		6
Complicated management of transfusion slots	4			X	5
Stability and variability of transfusion perceptions (3 of 3 subthemes)
Views consistent and similar to colleagues	6			X	7
Views broadened through haematology exposure	4	X	X	X	7
Patients’ transfusion perceptions variable	1			X	2