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van Galen K, Lavin M, Skouw-Rasmussen N, Fischer K, Noone D, Pollard D, Mauser-Bunschoten E, Khair K, Gomez K, van Loon E, Bagot CN, Elfvinge P, d'Oiron R, Abdul-Kadir R. European principles of care for women and girls with inherited bleeding disorders. Haemophilia 2021; 27:837-847. [PMID: 34343384 DOI: 10.1111/hae.14379] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/07/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Despite increasing awareness of issues faced by women and girls with inherited BDs (WGBD), standards of care are lacking, with disparities in diagnosis and treatment for WGBD across Europe. We aimed to develop practical principles of care (PoC) to promote standardization of care for WGBD within European Haemophilia Treatment and Comprehensive Care Centres (HTC/CCCs). METHODS The co-creation process, supported by the European Association for Haemophilia and Allied Disorders, consisted of four multidisciplinary meetings with health care providers (HCPs) experienced in WGBD care, and European Haemophilia Consortium representatives, combined with broad patient and HCP consultations in the European haemophilia community. Relevant medical societies outside Europe were contacted for confirmation. RESULTS We developed ten PoC for WGBD, stressing the importance and benefits of a centralized, multidisciplinary, comprehensive, family-centred approach to support and manage WGBD during all life stages. These PoC emphasise the right to equitable access and quality of care for all people with BDs, irrespective of gender. Multiple medical societies outside Europe also confirmed their support for endorsement. CONCLUSIONS Ten PoC for WGBD evolved from an iterative process among stakeholders, supported by relevant medical societies worldwide. These PoC can serve as a benchmark for diagnosis and comprehensive multidisciplinary management of WGBD, and improve awareness of their unique challenges. They offer a framework to guide HTC/CCCs in providing equitable care for all WGBD, both in their own services and in other healthcare settings. Implementation of these principles aims to positively impact the health, wellbeing and quality of life for WGBD.
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Affiliation(s)
- Karin van Galen
- Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Michelle Lavin
- Irish Centre for Vascular Biology, School of Pharmacy and Biomedical Sciences, RCSI, Dublin and National Coagulation Centre, St. James' Hospital, Dublin, Ireland
| | | | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands
| | - Declan Noone
- President, European Haemophilia Consortium, Brussels, Belgium
| | - Debra Pollard
- Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | | | - Kate Khair
- Director of Research, Haemnet, London, UK
| | - Keith Gomez
- Haemophilia Centre and Thrombosis Unit, Royal Free London NHS Foundation Trust, London, UK
| | | | | | - Petra Elfvinge
- Department of Haematology, Karolinska University, Stockholm, Sweden
| | - Roseline d'Oiron
- Centre de Référence de l'Hémophilie et des Maladies Hémorragiques Constitutionnelles, APHP Paris Saclay - Hôpital Bicêtre and Inserm, U 1176 Le Kremlin Bicêtre, France
| | - Rezan Abdul-Kadir
- Department of Obstetrics and Gynaecology, Royal Free London NHS Foundation Trust and Institute for Women's Health, University College London, London, UK
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van Galen KPM, d’Oiron R, James P, Abdul‐Kadir R, Kouides PA, Kulkarni R, Mahlangu JN, Othman M, Peyvandi F, Rotellini D, Winikoff R, Sidonio RF. A new hemophilia carrier nomenclature to define hemophilia in women and girls: Communication from the SSC of the ISTH. J Thromb Haemost 2021; 19:1883-1887. [PMID: 34327828 PMCID: PMC8361713 DOI: 10.1111/jth.15397] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 12/21/2022]
Abstract
Hemophilia A and B predominantly attracts clinical attention in males due to X-linked inheritance, introducing a bias toward female carriers to be asymptomatic. This common misconception is contradicted by an increasing body of evidence with consistent reporting on an increased bleeding tendency in hemophilia carriers (HCs), including those with normal factor VIII/IX (FVIII/IX) levels. The term HC can hamper diagnosis, clinical care, and research. Therefore, a new nomenclature has been defined based on an open iterative process involving hemophilia experts, patients, and the International Society on Thrombosis and Haemostasis (ISTH) community. The resulting nomenclature accounts for personal bleeding history and baseline plasma FVIII/IX level. It distinguishes five clinically relevant HC categories: women/girls with mild, moderate, or severe hemophilia (FVIII/IX >0.05 and <0.40 IU/ml, 0.01-0.05 IU/ml, and <0.01 IU/ml, respectively), symptomatic and asymptomatic HC (FVIII/IX ≥0.40 IU/ml with and without a bleeding phenotype, respectively). This new nomenclature is aimed at improving diagnosis and management and applying uniform terminologies for clinical research.
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Affiliation(s)
- Karin P. M. van Galen
- Van CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Roseline d’Oiron
- Centre de Référence de l’Hémophilie et des Maladies Hémorragiques ConstitutionnellesAPHP Paris Saclay ‐ Hôpital Bicêtre and Inserm U 1176Le Kremlin BicêtreFrance
| | - Paula James
- Department of MedicineQueen’s UniversityKingstonOntarioCanada
| | - Rezan Abdul‐Kadir
- Department of Obstetrics and Gynaecology and Katharine Dormandy Haemophilia and Thrombosis UnitThe Royal Free Foundation Hospital and Institute for Women’s HealthUniversity College LondonLondonUK
| | - Peter A. Kouides
- University of RochesterRochesterNew YorkUSA
- The Mary M. Gooley Hemophilia CenterRochesterNew YorkUSA
| | | | - Johnny N. Mahlangu
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Maha Othman
- School of MedicineQueen’s University, and School of Baccalaureate NursingSt. Lawrence CollegeKingstonOntarioCanada
| | - Flora Peyvandi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoAngelo Bianchi Bonomi Hemophilia and Thrombosis CenterMilanItaly
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | | | - Rochelle Winikoff
- Department of PediatricService of HematologySainte‐Justine HospitalMontrealQuebecCanada
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Rhynders PA, Sayers CA, Presley RJ, Thierry JM. Providing young women with credible health information about bleeding disorders. Am J Prev Med 2014; 47:674-80. [PMID: 25245800 PMCID: PMC4493902 DOI: 10.1016/j.amepre.2014.07.040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/14/2014] [Accepted: 07/25/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Approximately 1% of U.S. women may have an undiagnosed bleeding disorder, which can diminish quality of life and lead to life-threatening complications during menstruation, childbirth, and surgery. PURPOSE To understand young women's knowledge, attitudes, and perceptions about bleeding disorders and determine the preferred messaging strategy (e.g., gain- versus loss-framed messages) for presenting information. METHODS In September 2010, a web-assisted personal interview of women aged 18-25 years was conducted. Preliminary analyses were conducted in 2011 with final analyses in 2013. In total, 1,243 women participated. Knowledge of blood disorders was tabulated for these respondents. Menstrual experiences of women at risk for a bleeding disorder were compared with those not at risk using chi-square analyses. Perceived influence of gain- versus loss-framed messages also was compared. RESULTS Participants knew that a bleeding disorder is a condition in which bleeding takes a long time to stop (77%) or blood does not clot (66%). Of the women, 57% incorrectly thought that a bleeding disorder is characterized by thin blood; many were unsure if bleeding disorders involve blood types, not getting a period, or mother and fetus having a different blood type. Women at risk for a bleeding disorder were significantly more likely to report that menstruation interfered with daily activities (36% vs 9%); physical or sports activities (46% vs 21%); social activities (29% vs 7%); and school or work activities (20% vs 9%) than women not at risk. Gain-framed messages were significantly more likely to influence women's decisions to seek medical care than parallel loss-framed messages. Findings suggest that the most influential messages focus on knowing effective treatment is available (86% gain-framed vs 77% loss-framed); preventing pregnancy complications (79% gain- vs 71% loss-framed); and maintaining typical daily activities during menstrual periods. CONCLUSIONS Lack of information about bleeding disorders is a serious public health concern. Health communications focused on gain-framed statements might encourage symptomatic young women to seek diagnosis and treatment. These findings and corresponding recommendations align with Healthy People 2020 and with CDC's goal of working to promote the health, safety, and quality of life of women at every life stage.
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Affiliation(s)
| | - Cynthia A Sayers
- The Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia
| | - Rodney J Presley
- The Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia
| | - JoAnn M Thierry
- The Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, Georgia.
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Riley WJ, Lownik EM, Scutchfield FD, Mays GP, Corso LC, Beitsch LM. Public health department accreditation: setting the research agenda. Am J Prev Med 2012; 42:263-71. [PMID: 22341163 DOI: 10.1016/j.amepre.2011.10.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 09/11/2011] [Accepted: 10/28/2011] [Indexed: 10/28/2022]
Abstract
Health department accreditation is one of the most important initiatives in the field of public health today. The Public Health Accreditation Board (PHAB) is establishing a voluntary accreditation system for more than 3000 state, tribal, territorial, and local health departments using domains, standards, and measures with which to evaluate public health department performance. In addition, public health department accreditation has a focus on continuous quality improvement to enhance capacity and performance of health departments in order to advance the health of the population. In the accreditation effort, a practice-based research agenda is essential to build the scientific base and advance public health department accreditation as well as health department effectiveness. This paper provides an overview of public health accreditation and identifies the research questions raised by this accreditation initiative, including how the research agenda will contribute to better understanding of processes underlying the delivery of services by public health departments and how voluntary accreditation may help improve performance of public health departments.
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Affiliation(s)
- William J Riley
- Division of Health Policy and Management, University of Minnesota, Minneapolis, Minnesota, USA.
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