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Hosseini SMR, Mousavi SH, Mesbah-Namin SA, Tabibian S, Dorgalaleh A. Health-related quality of life in persons with haemophilia in Afghanistan. Haemophilia 2023; 29:770-775. [PMID: 36867665 DOI: 10.1111/hae.14772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Haemophilia is the most common severe congenital bleeding disorder and can significantly influence patients' quality of life. The health-related quality of life (HRQoL) is a multi-dimensional concept that assess effect of different aspects of health status, including physical, mental, and social domains. Identification of the factors affecting the HRQoL of Persons with Haemophilia (PWH) can guide health care system to better management of patients. AIM The aim of the present study is to evaluate HRQoL in PWH in Afghanistan. METHODS This cross-sectional study was conducted on 100 PWH in Kabul City, Afghanistan. Data were collected using 36-Item-Short-Form Health Survey (SF-36) questionnaire and analysed using correlation coefficients and regression analysis. RESULTS The mean scores for the SF-36 questionnaire 8 domains range from 33 ± 38.3 to 58.15 ± 20.5. The highest mean value belongs to physical function (PF) (58.15), whereas the lowest is related to restriction of activities due to emotional problems (RE) (33.00). A significant association (p < .005) was observed between all domains of SF-36 and patients' age except for PF (p = .055) and general health (GH) (p = .75). A significant association was also observed between all HRQoL domains and the severity of haemophilia (p < .001). The severity of haemophilia was the significant predictor for Physical Component Summary (PCS) and Mental Component Summary (MCS) (p < .001). CONCLUSION Due to the reduced HRQoL in Afghan PWH, special attention by health care system should be paid to improve patients' quality of life.
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Affiliation(s)
| | - Sayed Hamid Mousavi
- Medical Research Center, Kateb University, Kabul, Afghanistan.,Afghanistan National Charity Organization for Special Diseases (ANCOSD), Kabul, Afghanistan
| | - Seyed Alireza Mesbah-Namin
- Faculty of Medical Sciences, Department of Clinical Biochemistry, Tarbiat Modares University, Tehran, Iran
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2
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Cheung YT, Lam PH, Lam HHW, Ma CT, Leung AWK, Wong RSM, Li CK. Treatment Adherence and Health-Related Quality of Life in Patients with Hemophilia in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116496. [PMID: 35682087 PMCID: PMC9180237 DOI: 10.3390/ijerph19116496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/17/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022]
Abstract
Background: This study aims to identify factors affecting health-related quality of life (HRQoL) in Chinese patients with hemophilia in Hong Kong, and to examine the association between treatment adherence and HRQoL outcomes. Methods: Patients with hemophilia A or B from a non-governmental organization reported their HRQoL and treatment adherence to prophylactic therapy using validated tools. Univariate tests and multivariable regression analysis were used to compare differences in outcomes across clinically relevant subgroups. Results: Fifty-six patients were recruited (mean age 30.4 [17.4] years; majority hemophilia A: 75%; moderate-to-severe severity: 88%). Patients who received prophylactic treatment reported fewer work/school problems (25.8 [18.9] versus 51.5 [26.3]; p = 0.001) than those who received on-demand therapy. The multivariable model showed that older age (B = 0.42, 95% CI = 0.093−0.75) and living in public housing (B = 10.24, 95% CI = 0.70−19.77) were associated with worse HRQoL. Older age was associated with treatment non-adherence (r = 0.66, p < 0.0001). Patients with poor adherence tended to report worse functioning in sports/leisure (r = 0.31, p = 0.033). Conclusions: Our results suggest that patients who were older, had lower education attainment and received on-demand treatment had poorer perception of their health. Improving adherence may lead to better HRQoL. Future work includes evaluating the occupational needs prospectively in this population.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
- Correspondence: ; Tel.: +852-3943-6833; Fax: +852-2603-5295
| | - Pok Hong Lam
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.H.L.); (A.W.K.L.); (C.K.L.)
| | | | - Chung-Tin Ma
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Alex Wing Kwan Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.H.L.); (A.W.K.L.); (C.K.L.)
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Raymond Siu Ming Wong
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Chi Kong Li
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (P.H.L.); (A.W.K.L.); (C.K.L.)
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
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3
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Reduced cardiovascular morbidity in patients with hemophilia: results of a 5-year multinational prospective study. Blood Adv 2021; 6:902-908. [PMID: 34879394 PMCID: PMC8945305 DOI: 10.1182/bloodadvances.2021005260] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/08/2021] [Indexed: 11/20/2022] Open
Abstract
In this prospective study, PWH have a lower-than-predicted incidence of CVD. The QRISK-2011 risk predictor is not valid for PWH.
Hemophilia is a congenital bleeding disorder caused by low levels of clotting factor VIII or IX. The life expectancy of people with hemophilia (PWH) has increased with the availability of clotting factor concentrates. At the same time, the incidence of cardiovascular disease (CVD) has increased; in retrospective studies, there are conflicting data regarding if, despite this increase, the incidence is still lower than in the general population. We prospectively compared the incidence of CVD in PWH vs the predicted incidence. This prospective, multicenter, observational study included adult PWH (aged >30 years) from The Netherlands and United Kingdom. They were followed up for a 5-year period, and CVD incidence was compared with a predicted event rate based on the QRISK2-2011 CVD risk model. The primary end point was the observed fatal and nonfatal CVD incidence after 5 years compared with the estimated events and in relation to severity of hemophilia. The study included 709 patients, of whom 687 (96.9%) completed 5 years’ follow-up or reached an end point. For 108 patients, the QRISK score could not be calculated at inclusion. For the remaining 579, fewer CVD events were observed than predicted: 9 vs 24 (relative risk, 0.38; 95% confidence interval, 0.18-0.80; P = .01), corresponding with an absolute risk reduction of 2.4%. Severe hemophilia treated on demand had the highest risk reduction. There was no statistically significant relation between severity of hemophilia and incidence of CVD. In hemophilia, a lower-than-predicted CVD incidence was found, supporting the theory that hemophilia protects against CVD. The study is registered at www.clinicaltrials.gov as #NCT01303900.
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Ratajová K, Blatný J, Poláčková Šolcová I, Meier Z, Horňáková T, Brnka R, Tavel P. Social support and resilience in persons with severe haemophilia: An interpretative phenomenological analysis. Haemophilia 2020; 26:e74-e80. [PMID: 32291937 PMCID: PMC7383587 DOI: 10.1111/hae.13999] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/25/2020] [Indexed: 12/21/2022]
Abstract
Introduction Haemophilia is a hereditary haemorrhagic disorder characterized by deficiency or dysfunction of coagulation factors. Recurrent joint and muscle bleeds lead to progressive musculoskeletal damage. Haemophilia affects patients physically but also socially and psychologically. Traumatic experiences, chronic stress and illnesses can lead to mental disorders, but many persons with haemophilia maintain a highly positive outlook. Aim To explore qualitatively which coping mechanisms persons with haemophilia use and in what way they help them to live with their diagnosis. Methods We recruited five adults with haemophilia and conducted semi‐structured face‐to‐face interviews. Transcripts were analysed using interpretative phenomenological analysis (IPA). Results Two core themes emerged from the analysis: social support as an external factor and resilience as an internal factor of coping with the disease. Persons with haemophilia usually need help with health‐related complications, and this affects the social support they require. Their wider support network tends to involve family and friends but also healthcare professionals and other specialists. This network provides practical help but also functions as an important psychological protective factor. An unexpected finding was that persons with haemophilia want not only to receive support but are also keen to offer support to others. Conclusion These findings can help identify persons who provide most support to people suffering from haemophilia. Haemophilic centres should include in their teams psychologists and social workers and offer individual and group therapy to their clients, group meetings for friends and families of persons with haemophilia, provide learning resources to teachers aiming to incorporate children with haemophilia in their peer group, and organize Balint groups for physicians, psychologists and other healthcare professionals.
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Affiliation(s)
- Kateřina Ratajová
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Jan Blatný
- Department of Paediatric Haematology, Haemophilia Comprehensive Care Centre, Children's University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Iva Poláčková Šolcová
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.,Institute of Psychology, Czech Academy of Sciences, Praha, Czech Republic
| | - Zdeněk Meier
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Tekla Horňáková
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Robert Brnka
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic.,First Department of Internal Medicine, Faculty of Medicine Comenius University Bratislava, Bratislava, Slovak Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
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5
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Torres-Ortuño A, Cid-Sabatel R, Barbero J, García-Dasí M. Life experience of the adult and ageing patient with haemophilia. Practical aspects for psychological support. Vox Sang 2017; 112:301-309. [DOI: 10.1111/vox.12501] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Affiliation(s)
- A. Torres-Ortuño
- Asociación Regional Murciana de Hemofilia; Departamento de Psiquiatria y Psicologia Social; Facultad de Medicina; Universidad de Murcia; Murcia Spain
| | | | - J. Barbero
- Hospital Universitario La Paz; Madrid Spain
| | - M. García-Dasí
- Instituto de Investigaciones Sanitarias La Fe; Unidad de Hemostasia y Trombosis; Hospital Universitario y Politécnico La Fe; Valencia Spain
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6
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Astermark J, Hart D, Lobet S, Blatný J, d'Oiron R, Kenet G, Dolan G, Libotte V, Hermans C. Partnering to change the world for people with haemophilia: 6(th) Haemophilia Global Summit, Prague, Czech Republic, 24-26(th) September 2015. Eur J Haematol 2017; 97 Suppl 84:3-23. [PMID: 27292051 DOI: 10.1111/ejh.12761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The 6(th) Haemophilia Global Summit was held in Prague, Czech Republic, in September 2015. The programme was designed by an independent Scientific Steering Committee of haemophilia experts and aimed to share optimal management strategies for haemophilia at all life stages, explore recent potential advances in the management of haemophilia A and B and discuss challenges in haemophilia care. In this supplement from the meeting, Dan Hart reviews the lessons that can be learnt from cost-constrained environments with regard to improving care for people with haemophilia globally. Sébastien Lobet discusses the importance of physical activity for optimising care and Roseline d'Oiron and Jan Blatný consider the role of real-world data in understanding the effect of treatment in a clinical setting over the long term and the true impact of treatment on the day-to-day life of the patient. Gili Kenet addresses the current challenges relating to the optimal management of prophylaxis, and Gerry Dolan and Cedric Hermans discuss the value of pharmacokinetic (PK) parameters in informing treatment decisions. Cedric Hermans and Valérie Libotte explore the importance of considering social and occupational development factors as an integral part of haemophilia care, and Jan Astermark reviews key strategies to predict and prevent inhibitor development.
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Affiliation(s)
- Jan Astermark
- Department of Hematology and Vascular Diseases, Skåne University Hospital, Malmö, Sweden
| | - Dan Hart
- The Royal London Hospital Haemophilia Centre, Barts and The London School of Medicine and Dentistry, QMUL, London, UK
| | - Sébastien Lobet
- Haemostasis and Thrombosis Unit, Division of Haematology, Haemophilia Clinic, Saint-Luc University Hospital, Brussels, Belgium
| | - Jan Blatný
- Children's University Hospital Brno, Brno, Czech Republic
| | - Roseline d'Oiron
- Hôpital Bicêtre AP-HP, Paris XI University, Le Kremlin-Bicêtre, France
| | - Gili Kenet
- National Hemophilia Center, Sheba Medical Center, Tel HaShomer, Israel
| | | | - Valérie Libotte
- Service externe de prévention et de protection au travail - CESI - 1200 Brussels, Belgium
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7
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Yang S, Ge M, Liu S, Liu Y, Cen M, Pan C. A Preliminary Study of Age and Sex of People with Hemophilia. Health (London) 2017. [DOI: 10.4236/health.2017.93028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Salomon T, Chaves DG, Brener S, Martins PRJ, Mambrini JVM, Peixoto SV. Determining the health-related quality of life in individuals with haemophilia in developing economies: results from the Brazilian population. Haemophilia 2016; 23:42-49. [PMID: 27928900 DOI: 10.1111/hae.13130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Several studies show the negative impact of haemophilia in health-related quality of life (HRQOL). This issue is not well explored in developing countries. OBJECTIVES This cross-sectional study aimed to evaluate the HRQOL and its associated factors in patients with haemophilia A/B in Brazil. Data were collected by questionnaire and in medical records, including a Portuguese version of Haem-A-Qol. RESULTS Brazilian patients were invited to the study and 175 participants (147 haemophilics A and 28 haemophilics B) were included. The total score of the Haem-A-QoL had a median of 36.96 (range of 0-100), with worse performance in 'sport and leisure' and best on 'relationships' fields. HRQOL was worst among the older participants, the less educated, non-white, non-working, who were hospitalized in the last year, who did not have a single medical consultation and among those with the highest number of affected joints. Moreover, patients with hepatitis B had a significantly worse HRQOL in the domain 'sports and leisure', also observed in married patients. Otherwise, married individuals reported better HRQOL on 'dealing with the disease' domain. Patients with haemophilia B reported worse HRQOL in the domain 'self-perception'. CONCLUSION The results obtained could be helpful in guidance of haemophilia treatment which is determinant to improve HRQoL of the most vulnerable groups of patients. This work also reinforced the relevance of joint bleeds in all aspects of HRQoL in haemophilic patients. The use of prophylactic factor concentrates and multidisciplinary treatments could contribute to improve the quality of life in haemophilia.
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Affiliation(s)
- T Salomon
- Programa de Pós-Graduação em Saúde Coletiva - Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil.,Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil
| | - D G Chaves
- Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
| | - S Brener
- Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
| | - P R J Martins
- Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
| | - J V M Mambrini
- Fiocruz Minas - Centro de Pesquisas René Rachou, Belo Horizonte, Minas Gerais, Brazil
| | - S V Peixoto
- Programa de Pós-Graduação em Saúde Coletiva - Fiocruz Minas, Belo Horizonte, Minas Gerais, Brazil.,Grupo de Qualidade de Vida em Hematologia e Hemoterapia, Belo Horizonte, Minas Gerais, Brazil.,Fiocruz Minas - Centro de Pesquisas René Rachou, Belo Horizonte, Minas Gerais, Brazil.,Escola de Enfermagem - Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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9
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Shima M, Hanabusa H, Taki M, Matsushita T, Sato T, Fukutake K, Fukazawa N, Yoneyama K, Yoshida H, Nogami K. Factor VIII-Mimetic Function of Humanized Bispecific Antibody in Hemophilia A. N Engl J Med 2016; 374:2044-53. [PMID: 27223146 DOI: 10.1056/nejmoa1511769] [Citation(s) in RCA: 325] [Impact Index Per Article: 40.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND In patients with severe hemophilia A, standard treatment is regular prophylactic and episodic intravenous infusions of factor VIII. However, these treatments are burdensome, especially for children, and may lead to the formation of anti-factor VIII alloantibodies (factor VIII inhibitors). Emicizumab (ACE910), a humanized bispecific antibody mimicking the cofactor function of factor VIII, was developed to abate these problems. METHODS We enrolled 18 Japanese patients with severe hemophilia A (with or without factor VIII inhibitors) in an open-label, nonrandomized, interindividual dose-escalation study of emicizumab. The patients received subcutaneous emicizumab weekly for 12 weeks at a dose of 0.3, 1.0, or 3.0 mg per kilogram of body weight (cohorts 1, 2, and 3, respectively). The end points were safety and pharmacokinetic and pharmacodynamic profiles. An additional, exploratory end point was the annualized bleeding rate, calculated as 365.25 times the number of bleeding episodes, divided by the number of days in the treatment period as compared with the 6 months before enrollment. RESULTS Emicizumab was associated with neither serious adverse events nor clinically relevant coagulation abnormalities. Plasma concentrations of emicizumab increased in a dose-dependent manner. Activated partial-thromboplastin times remained short throughout the study. The median annualized bleeding rates in cohorts 1, 2, and 3 decreased from 32.5 to 4.4, 18.3 to 0.0, and 15.2 to 0.0, respectively. There was no bleeding in 8 of 11 patients with factor VIII inhibitors (73%) and in 5 of 7 patients without factor VIII inhibitors (71%). Episodic use of clotting factors to control bleeding was reduced. Antibodies to emicizumab did not develop. CONCLUSIONS Once-weekly subcutaneous administration of emicizumab markedly decreased the bleeding rate in patients who had hemophilia A with or without factor VIII inhibitors. (Funded by Chugai Pharmaceutical; JapicCTI number, 121934.).
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MESH Headings
- Adolescent
- Adult
- Antibodies, Bispecific/blood
- Antibodies, Bispecific/pharmacology
- Antibodies, Bispecific/therapeutic use
- Antibodies, Monoclonal, Humanized/blood
- Antibodies, Monoclonal, Humanized/pharmacology
- Antibodies, Monoclonal, Humanized/therapeutic use
- Child
- Dose-Response Relationship, Drug
- Drug Therapy, Combination
- Factor IX/analysis
- Factor VIII/antagonists & inhibitors
- Factor VIII/therapeutic use
- Factor X/analysis
- Hemophilia A/complications
- Hemophilia A/drug therapy
- Hemophilia A/immunology
- Hemorrhage/etiology
- Hemorrhage/prevention & control
- Humans
- Injections, Subcutaneous/adverse effects
- Male
- Middle Aged
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Affiliation(s)
- Midori Shima
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Hideji Hanabusa
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Masashi Taki
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Tadashi Matsushita
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Tetsuji Sato
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Katsuyuki Fukutake
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Naoki Fukazawa
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Koichiro Yoneyama
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Hiroki Yoshida
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
| | - Keiji Nogami
- From Nara Medical University, Kashihara (M.S., K.N.), Ogikubo Hospital (H.H.), Tokyo Medical University (K.F.), and Chugai Pharmaceutical (N.F., K.Y., H.Y.), Tokyo, St. Marianna University School of Medicine, Kawasaki (M.T.), Nagoya University, Nagoya (T.M.), and University of Occupational and Environmental Health, Kitakyushu (T.S.) - all in Japan
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Curtis R, Baker J, Riske B, Ullman M, Niu X, Norton K, Lou M, Nichol MB. Young adults with hemophilia in the U.S.: demographics, comorbidities, and health status. Am J Hematol 2015; 90 Suppl 2:S11-6. [PMID: 26619192 DOI: 10.1002/ajh.24218] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 10/13/2015] [Indexed: 12/19/2022]
Abstract
Improvements in hemophilia care over the last several decades might lead to expectations of a near-normal quality of life for young adults with hemophilia. However, few published reports specifically examine health status indicators in this population. To remedy this knowledge gap, we examined the impact of hemophilia on physical and social functioning and quality of life among a national US cohort of 141 young men with hemophilia aged 18-34 years of age who received care at 10 geographically diverse, federally funded hemophilia treatment centers in 11 states between 2005 and 2013 and enrolled in the Hemophilia Utilization Group Studies. Indicators studied included educational achievement, employment status, insurance, health-related quality of life, and prevalence of the following comorbidities: pain, range of motion limitation, overweight/obesity, and viral status. The cohort was analyzed to compare those aged 18-24 to those aged 25-34 years. When compared to the general US adult population, this nationally representative cohort of young US adults with hemophilia experienced significant health and social burdens: more liver disease, joint damage, joint pain, and unemployment as well as lower high-school graduation rates. Nearly half were overweight or obese. Conversely, this cohort had higher levels of health insurance and equivalent mental health scores. While attention has typically focused on newborns, children, adolescents, and increasingly, on older persons with hemophilia, our findings suggest that a specific focus on young adults is warranted to determine the most effective interventions to improve health and functioning for this apparently vulnerable age group.
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Affiliation(s)
| | - Judith Baker
- The Center for Comprehensive Care & Diagnosis of Inherited Blood Disorders, Orange, CA and University of California Los Angeles; California
| | - Brenda Riske
- University of Colorado, Hemophilia and Thrombosis Center; Aurora Colorado
| | - Megan Ullman
- Gulf States Hemophilia & Thrombophilia Center, University of Texas Health Science Center at Houston; Texas
| | - Xiaoli Niu
- University of Southern California; Los Angeles California
| | - Kristi Norton
- University of Colorado, Hemophilia and Thrombosis Center; Aurora Colorado
| | - Mimi Lou
- University of Southern California; Los Angeles California
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11
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Bullying in medically fragile youth: a review of risks, protective factors, and recommendations for medical providers. J Dev Behav Pediatr 2015; 36:285-301. [PMID: 25923529 DOI: 10.1097/dbp.0000000000000155] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Bullying is a common child and adolescent phenomenon that has concurrent and long-term implications for victims' psychological, psychosomatic, social, and academic functioning. Youth with chronic illnesses are at increased risk for being bullied, but few studies have evaluated specific risk and protective factors for medically fragile youth. Despite recommendations by the American Academy of Pediatrics and the Society for Adolescent Medicine that pediatric health care providers should contribute to bullying prevention and intervention efforts, researchers also have yet to identify the best ways for providers to intervene with medically fragile youth. In this article, the authors review risk and protective factors for bullying among healthy samples. Then, the authors specifically address the ways in which these risk and protective factors are likely to apply to children with fragile medical conditions, and they provide summaries of extant bullying research for selected examples of medically fragile pediatric populations. Finally, the authors present recommendations for intervening with medically fragile youth and suggest several areas in which additional research is needed.
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