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Komatsu K, Kimura S, Kiryu Y, Watanabe A, Kinai E, Oka S, Kimura S, Fujitani J, Ogata M, Minamimoto R, Hotta M, Yokoyama K, Noguchi T, Imai K. Prevalence and associated factors of low vigor in patients living with HIV and hemophilia in Japan: A cross-sectional observational study. Glob Health Med 2024; 6:174-182. [PMID: 38947408 PMCID: PMC11197162 DOI: 10.35772/ghm.2023.01108] [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: 10/20/2023] [Revised: 04/14/2024] [Accepted: 04/30/2024] [Indexed: 07/02/2024]
Abstract
People living with human immunodeficiency virus (HIV) are at high risk of mental health problems. However, little is known about this risk in HIV-infected patients with hemophilia (HPH) who contracted the virus through blood products. This cross-sectional, observational study assessed patients' mood states and the factors associated with them among Japanese HPH to evaluate the need for psychosocial support. HPH completed self-administered questionnaires (Profile of Mood States [POMS] and General Health Questionnaire-28), neuropsychological tests, and brain magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography/computerized tomography scans. HIV-infected patients with no hemophilia (HPnH) completed POMS and neuropsychological tests. Socio-demographic characteristics and HIV- and hemophilia-related data were obtained from participants' medical records and interviews. A Mann-Whitney U test and chi-squared analyses were conducted. Fifty-six HPH and 388 HPnH completed the questionnaires and neuropsychological tests. HPH had a significantly lower prevalence of tension-anxiety (HPH, 7%; HPnH, 18%; p = 0.049) and a significantly higher prevalence of low vigor (HPH, 63%; HPnH, 32%; p < 0.001). Low vigor in HPH was significantly associated with impaired executive function (low vigor, 66%; high vigor, 33%; p = 0.019) and a social dysfunction score ≥ 3 (moderate; low vigor, 26%; high vigor, 5%; p = 0.047). Our results highlight the high prevalence of low vigor among HPH, leading to impairments in executive and social functions. Therefore, healthcare workers need to pay attention to the vigor, executive function, and social function of HPH.
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Affiliation(s)
- Kensuke Komatsu
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Faculty of Human Sciences, Wako University, Tokyo, Japan
| | - Sota Kimura
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoko Kiryu
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Aki Watanabe
- Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Ei Kinai
- Department of Laboratory Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kimura
- The Center for Education and Research of Infection Prevention and Control, Tokyo Healthcare University, Tokyo, Japan
| | - Junko Fujitani
- Department of Rehabilitation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mikiko Ogata
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryogo Minamimoto
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kota Yokoyama
- Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoyuki Noguchi
- Department of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Koubun Imai
- Department of Psychiatry, Hitachi Medical Education and Research Center, University of Tsukuba Hospital, Ibaraki, Japan
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Velvin G, Dammann B, Haagensen T, Johansen H, Strømme H, Geirdal AØ, Bathen T. Work participation in adults with rare genetic diseases - a scoping review. BMC Public Health 2023; 23:910. [PMID: 37208707 DOI: 10.1186/s12889-023-15654-3] [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: 11/09/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Work participation is a crucial aspect of health outcome and an important part of life for most people with rare genetic diseases. Despite that work participation is a social determinant of health and seems necessary for understanding health behaviours and quality of life, it is an under-researched and under-recognized aspect in many rare diseases. The objectives of this study was to map and describe existing research on work participation, identify research gaps, and point to research agendas in a selection of rare genetic diseases. METHODS A scoping review was performed by searching relevant literature in bibliographic databases and other sources. Studies addressing work participation in people with rare genetic diseases published in peer reviewed journals were assessed using EndNote and Rayyan. Data were mapped and extracted based on the research questions concerning the characteristics of the research. RESULTS Of 19,867 search results, 571 articles were read in full text, and 141 satisfied the eligibility criteria covering 33 different rare genetic diseases; 7 were reviews and 134 primary research articles. In 21% of the articles the primary aim was to investigate work participation. The extent of studies varied between the different diseases. Two diseases had more than 20 articles, but most had only one or two articles. Cross-sectional quantitative studies were predominant, with few utilizing prospective or qualitative design. Nearly all articles (96%) reported information about work participation rate, and 45% also included information about factors associated with work participation and work disability. Due to differences in methodologies, cultures and respondents, comparison between and within diseases are difficult. Nevertheless, studies indicated that many people with different rare genetic diseases experience challenges related to work, closely associated to the symptoms of the disease. CONCLUSION While studies indicate high prevalence of work disability in many patients with rare diseases, the research is scarce and fragmented. More research is warranted. Information about the unique challenges of living with different rare diseases is crucial for health and welfare systems to better facilitate work participation. In addition, the changing nature of work in the digital age, may also open up new possibilities for people with rare genetic diseases and should be explored.
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Affiliation(s)
- Gry Velvin
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway.
| | - Brede Dammann
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| | - Trond Haagensen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| | - Heidi Johansen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
| | - Hilde Strømme
- Library of Medicine and Science, University of Oslo, Oslo, Norway
| | - Amy Østertun Geirdal
- Department of Social Work, Child Welfare and Social Policy, Faculty of Social Science, Oslo Metropolitan University, Oslo, Norway
| | - Trine Bathen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Oslo, 1450, Norway
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Brown LJ, La HA, Li J, Brunner M, Snoke M, Kerr AM. The societal burden of haemophilia A. I - A snapshot of haemophilia A in Australia and beyond. Haemophilia 2020; 26 Suppl 5:3-10. [PMID: 32935397 DOI: 10.1111/hae.14102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/03/2020] [Accepted: 06/18/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Few studies, both in Australia and overseas, have examined the social impacts of living with haemophilia A (HA) or the economic costs associated with the disorder. The purpose of this paper is to examine the epidemiology and societal burden of people with HA (PwHA) in Australia, with a particular focus on men with this disorder. METHODS The epidemiology and societal burden of HA in Australia, with a particular focus on men with this disorder, were assessed, using data available in the Australian and international literature and publicly available data. RESULTS The mean annual prevalence of HA is approximately 1-2 per 10 000 males. Prophylactic treatment is used in one-quarter (25.1%) of people with moderate HA, and 82.2% of people with severe HA. Within the latter group, 16.1% have inhibitors for Factor VIII, predisposing them to worse morbidity, mortality and quality of life when compared to the non-inhibitor population. Joint pain and joint disease occur commonly in PwHA, with up to 70% of adults with HA experiencing joint problems. HA is associated with poor physical health, and PwHA miss school and work due to bleeding-related events. CONCLUSION HA is associated with substantial economic burden; with large differences in costs reported between countries. Overall, HA imposes a significant burden of disease on PwHA, their families and the community at large.
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Affiliation(s)
- Laurie J Brown
- NATSEM, Institute for Governance and Policy Analysis, University of Canberra, Canberra, ACT, Australia
| | - Hai A La
- NATSEM, Institute for Governance and Policy Analysis, University of Canberra, Canberra, ACT, Australia
| | - Jinjing Li
- NATSEM, Institute for Governance and Policy Analysis, University of Canberra, Canberra, ACT, Australia
| | | | - Martin Snoke
- Roche Products Pty Limited, Sydney, NSW, Australia
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Palareti L, Melotti G, Cassis F, Nevitt SJ, Iorio A. Psychological interventions for people with hemophilia. Cochrane Database Syst Rev 2020; 3:CD010215. [PMID: 32187661 PMCID: PMC7080553 DOI: 10.1002/14651858.cd010215.pub2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Managing hemophilia is challenging both in terms of medical treatment and its broad impact on many aspects of the individual's life, including self-perception. Several psychosocial issues are potentially relevant in the clinical management of hemophilia, including it being a chronic and incurable condition; e.g. people with hemophilia must adapt to optimally interact with peers and to practice sports - even choosing a sport represents an issue for perceived limitations, expectations and cultural influences on the individual and their family. People with hemophilia can react by denying their condition and its manifestations and not adhering to treatment. Due to the complexity of relationships surrounding genetic diseases, parents and relatives may have their own issues that contribute to making life easier or more difficult for the person with hemophilia. Anxiety, sadness and depression resulting in mental health disorders are reported in this population and may influence quality of life (QoL) depending on cultural background, religious beliefs, family support and other variables. OBJECTIVES Primarily to assess the effectiveness of psychological therapies for improving the ability of people with hemophilia to cope with their chronic condition. SEARCH METHODS We aimed to identify trials from the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, Embase and PsycINFO, CINAHL, MEDLINE and trial registries. We searched reference lists of included publications. Most recent search of the Group's register: 13 June 2019. SELECTION CRITERIA Randomized controlled trials (RCTs) and quasi-RCTs in people with hemophilia of any age or gender, type A or B, any severity, with or without inhibitors, with or without HIV or hepatitis C virus. All psychological interventions for promoting emotional, intellectual and spiritual wellness. Individual, group or family group therapy interventions were eligible. DATA COLLECTION AND ANALYSIS We independently assessed trials, extracted data and assessed the risk of bias and assessed the quality of the evidence using GRADE. MAIN RESULTS Seven trials were included (362 participants randomized, data from 264 participants available for analysis); six of parallel design and one a partial cross-over design. One multicenter trial was conducted in Canada; the remaining six were single centre undertaken in the UK, USA, Iran and in the Netherlands. All trials had a high risk of bias for participant blinding and use of patient-reported outcomes. Evidence was retrieved on four interventions: psycho-education (DVD plus information booklet versus information booklet alone; computerised learning versus no intervention); cognitive therapy (auto-hypnosis (self-hypnosis) versus control); and behavioural therapy (relaxation (progressive or self control) versus no treatment). We also aimed to assess psychodynamic therapy and systemic therapy, but no trials were identified. Heterogeneity of the outcome measures and measurements precluded meta-analyses. No trial reported the cost of the psychological intervention and family adjustment. DVD plus information booklet compared to information booklet alone One trial (108 participants) showed coping strategies may lower pre-contemplation scores and negative thoughts, mean difference (MD) -0.24 (95%CI -0.48 - 0.00, low-certainty evidence), however, other measures of coping strategies in the same trial suggest little or no difference between groups, e.g. contemplation, MD (-0.09, 95%CI -0.32 - 0.14, low-certainty evidence). The same trial measured QoL and showed little or no difference between treatment groups for the physical domain, MD 0.59 (95% CI -3.66 to 4.84, low-certainty evidence), but may improve scores in the mental health domain for those receiving the booklet plus DVD compared to booklet alone, MD (4.70, 95% CI 0.33 to 9.07, low-certainty evidence). Mood or personal well-being were not reported. Computerised learning compared to no intervention Two trials (57 participants) reported on interventions aimed at children and adolescents and their impact on promoting a sense of self-efficacy (primary outcome 'Mood and personal well-being'), but only one showed an increase, MD 7.46 (95%CI 3.21 to 11.71, 17 participants, very low-certainty evidence); the second did not report control group data. One trial (30 participants) showed the intervention did not improve self-efficacy in adults, but appropriate data could not be extracted. Two trials (47 participants) reported coping strategies; one only reported within-group differences from baseline, the second showed an increase from baseline in coping strategies in the Internet program group compared to the no intervention group (disease-specific knowledge, MD 2.45 (95% CI 0.89 to 4.01); self-management ability and transition readiness, MD 19.90 (95% CI 3.61 to 36.19; low-certainty evidence). One trial reported QoL but with insufficient information to calculate changes from baseline; no difference in post-treatment scores was seen between groups, MD -8.65, 95% CI -18.30 to 1.00, very low-certainty evidence). Auto-hypnosis (self-hypnosis) compared to control There were two older trials that reported on this intervention (50 participants) focusing mainly on the secondary outcome 'physical health'; only one trial reported the primary outcome 'mood and personal well-being' (only within-group differences in the treatment group). Coping strategies and QoL were not assessed in the trials. Relaxation (progressive or self control) compared to no treatment Only one trial (seven participants) from 1985, was included which focused on 'physical health' and did not report on any of our primary outcomes. AUTHORS' CONCLUSIONS Not all of the seven included trials analysed the effects of the interventions on our primary outcomes (mood and personal well-being, coping strategies and QoL). Three trials were conducted in the 1970s and 1980s using techniques of auto-hypnosis or relaxation and, in accordance with the needs and therapeutic possibilities of the time, they focused on secondary outcomes, e.g. frequency of bleeding (physical health) and adherence to the intervention. The four newer trials assessed psycho-educational interventions all mediated by the use of technologies (DVD or computer) and often created according to age needs of the target group. In these cases, attention was shifted to our pre-defined primary outcomes. This review has identified low- and very low-certainty evidence, prompting caution in its interpretation. The major problem we encountered was the heterogeneity of trial designs, of interventions and of outcome measures used across the trials. We strongly suggest that researchers consider developing a core outcome set to streamline future research; randomization was proven to be safe and acceptable, and blinding should be considered for those assessing patient-reported outcomes.
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Affiliation(s)
- Laura Palareti
- University of BolognaDepartment of Education Studies “G.M. Bertin”Via Filippo Re, 6BolognaItaly40126
| | - Giannino Melotti
- University of BolognaDepartment of Education Studies “G.M. Bertin”Via Filippo Re, 6BolognaItaly40126
| | - Frederica Cassis
- FMUSPHemophilia Centre of Hospital Das ClinicasUmburanas street 307San PabloSao PauloBrazil05464000
| | - Sarah J Nevitt
- University of LiverpoolDepartment of BiostatisticsBlock F, Waterhouse Building1‐5 Brownlow HillLiverpoolUKL69 3GL
| | - Alfonso Iorio
- McMaster UniversityDepartment of Health Research Methods, Evidence and Impact (HEI)1280 Main Street WestCRL ‐ 140HamiltonONCanadaL8S 4K1
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Limperg PF, Maurice-Stam H, Haverman L, Coppens M, Kruip MJHA, Eikenboom J, Grootenhuis MA, Peters M. Professional functioning of young adults with congenital coagulation disorders in the Netherlands. Haemophilia 2019; 25:e138-e145. [PMID: 30859671 PMCID: PMC6850762 DOI: 10.1111/hae.13698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2019] [Indexed: 01/17/2023]
Abstract
Introduction and Aim Suboptimal health‐related quality of life and lowered employment rates found in a previous study in young adults (YA) with congenital coagulation disorders (CCD) in the Netherlands underline the need for more insight into professional functioning of YA with CCD and into determinants of professional functioning. Methods Young adults (18‐30 years) with CCD participated in a cross‐sectional study. Professional functioning was assessed with the Work Productivity and Activity Impairment questionnaire (WPAI). Potential determinants were assessed with the Course of Life Questionnaire (CoLQ), Pediatric Quality of Life Inventory Young Adult version (PedsQL_YA), Illness Cognition Questionnaire (ICQ) and Haemophilia Activities List (HAL). Logistic regression analyses were performed in the complete sample of YA with CCD, and in YA men with haemophilia separately, to examine determinants of WPAI outcomes. Results Ninety‐four YA (77 men; mean age 24.1 years, SD 3.5 and 17 women; mean age 24.5 years, SD 3.8) with CCD (74% haemophilia A/B) participated. 74.5% of YA were paid employed for on average 30 hours per week. Of these, more than a quarter reported work impairment. Older age and a non‐severe type of haemophilia (in the sample of YA men with haemophilia) were associated with successful (paid) employment. No variables were associated with professional functioning (expressed as Presenteeism and Overall work impairment) in patients with CCD or haemophilia. Conclusion Three‐quarters of YA with CCD were successful in finding paid employment. Though absenteeism was low, YA with paid employment needs attention as a considerable part experienced work impairment.
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Affiliation(s)
- Perrine F Limperg
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotte Haverman
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Michiel Coppens
- Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Hemophilia Comprehensive Care Treatment Center, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen Eikenboom
- Department of Internal Medicine, Section Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Peters
- Department of Pediatric-Hematology and Hemophilia Comprehensive Care Treatment Center, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Hoxer CS, Zak M, Benmedjahed K, Lambert J. Utility valuation of health states for haemophilia and related complications in Europe and in the United States. Haemophilia 2018; 25:92-100. [PMID: 30461134 DOI: 10.1111/hae.13634] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 09/12/2018] [Accepted: 10/23/2018] [Indexed: 01/19/2023]
Abstract
INTRODUCTION There is currently a paucity of health utility data describing the consequences of haemophilia and related complications. AIM To quantify the impact of distinct stages of severity of haemophilia and disease-related complications on health-related quality of life, expressed as health utilities in Europe and the United States. METHODS Nine health state descriptions were developed based on literature review and interviews with haematologists and haemophilia patients. Three descriptions characterized the impact of mild, moderate and severe haemophilia without inhibitors. Six descriptions characterized disease-related complications added to the moderate haemophilia description (arthroscopic synovectomy, prosthetic joint replacement, chronic pain, spontaneous bleed, traumatic bleed and end-stage joint disease). Time trade-off (TTO) interviews were conducted with 100 adults from the general public in the UK, France, Germany, Italy, Sweden and the United States. Mean TTO-derived utility values were expressed on a scale from 0 (death) to 1 (full health). RESULTS Utility values obtained for the health states corresponding to mild (0.73-0.86), moderate (0.68-0.76) and severe (0.64-0.71) haemophilia followed the increase in severity. The addition of a complication to the "moderate" state leads to a decrease in the associated utility value. The most severe disutility (0.23-0.36) across all countries was associated with the burden of end-stage joint disease. CONCLUSIONS This study underlines the value that the French, Italian, German, Swedish, United States and UK populations ascribe to the avoidance of disease progression in haemophilia without inhibitors. Improved treatment options hold a potential for important benefits to haemophilia patients.
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Affiliation(s)
| | | | | | - Jérémy Lambert
- Patient-Centered Outcomes, Mapi, an ICON plc Company, Lyon, France
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Little T, Strodl E, Brown S, Mooney T. Parenting a child with haemophilia while living in a non-metropolitan area. ACTA ACUST UNITED AC 2018. [DOI: 10.17225/jhp00066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
The experience of living in a non-metropolitan area and parenting a child with haemophilia is relatively unknown. Using Interpretive Phenomenological Analysis (IPA), the following study explored the experiences of seven parents, from which four themes emerged: ‘bearing the brunt of diagnosis’ captures the impact of the diagnosis; ‘if you can’t help me, who can?’ reveals experiences with the health system; ‘tackling the challenge of treatment’ encompasses difficulties in adhering to the treatment regime; ‘I need you to understand’ reflects desires for others support and understanding. These themes should be considered when developing support systems and interventions for parents living in non-metropolitan areas.
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Affiliation(s)
- Trudi Little
- Queensland University of Technology, Brisbane , Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Victoria Park Road, Kelvin Grove , Queensland, 4059, Australia
| | - Simon Brown
- Lady Cilento Children’s Hospital, Brisbane , Australia
| | - Tara Mooney
- Queensland University of Technology, Brisbane , Australia
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Rambod M, Sharif F, Molazem Z, Khair K, von Mackensen S. Health-Related Quality of Life and Psychological Aspects of Adults With Hemophilia in Iran. Clin Appl Thromb Hemost 2018; 24:1073-1081. [PMID: 29575928 PMCID: PMC6714756 DOI: 10.1177/1076029618758954] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hemophilia causes bleeding that may affect patients’ psychological aspects and quality of life. This study aims to evaluate the impact of psychological aspects and pain on health-related quality of life (HRQoL) in adult patients with hemophilia. This cross-sectional study was conducted on 103 patients with hemophilia. Data were collected using hemophilia-specific quality of life, Depression Anxiety Stress Scales, and pain visual analogue scales. Data were analyzed using correlation coefficients, analysis of covariance, and regression analysis. The results showed that 71.7% of patients with hemophilia experienced pain on the study day. The mean score of HRQoL of patients with hemophilia was 51.09 (standard deviation = 19.37). Moreover, 57.4%, 64.6%, and 44.6% of the patients had mild to severe depression, anxiety, and stress, respectively. In addition, a significant association was observed between HRQoL and depression, anxiety, and severity of pain. In the regression model, 48% of changes in HRQOL were explained by the study variables, with the severity of pain and depression being significant predictors. Therefore, attention should be paid to these aspects to improve patients’ quality of life and psychosocial health.
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Affiliation(s)
- Masoume Rambod
- 1 Department of Medical Surgical Nursing, Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farkhondeh Sharif
- 2 Department of Mental Health and Psychiatric Nursing, Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Molazem
- 1 Department of Medical Surgical Nursing, Community-Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kate Khair
- 3 Haemophilia Centre, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,4 London South Bank University, London, UK
| | - Sylvia von Mackensen
- 5 Institute of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Limperg PF, Joosten MMH, Fijnvandraat K, Peters M, Grootenhuis MA, Haverman L. Male gender, school attendance and sports participation are positively associated with health-related quality of life in children and adolescents with congenital bleeding disorders. Haemophilia 2018; 24:395-404. [DOI: 10.1111/hae.13420] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2017] [Indexed: 12/19/2022]
Affiliation(s)
- P. F. Limperg
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
| | - M. M. H. Joosten
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
| | - K. Fijnvandraat
- Department of Pediatric-Hematology; Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Emma Children's Hospital; Amsterdam The Netherlands
| | - M. Peters
- Department of Pediatric-Hematology; Hemophilia Comprehensive Care Treatment Center; Academic Medical Center; Emma Children's Hospital; Amsterdam The Netherlands
| | - M. A. Grootenhuis
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
| | - L. Haverman
- Psychosocial Department; Emma Children's Hospital/Academic Medical Center; Amsterdam The Netherlands
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Chu WM, Ho HE, Wang JD, Chan WC, Liou YS, Ho WC, Hu SY, Tsan YT. Risk of major comorbidities among workers with hemophilia: A 14-year population-based study. Medicine (Baltimore) 2018; 97:e9803. [PMID: 29419677 PMCID: PMC5944666 DOI: 10.1097/md.0000000000009803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Multiple comorbidities, especially musculoskeletal dysfunction and cerebrovascular disease, remain barriers to normal social participation among persons with hemophilia (PWH). However, the relative health effects of such comorbidities on workers with hemophilia have seldom been explored. In this study, we investigated the incidence of comorbidities and their risk factors among workers with hemophilia.The study compared the incidence and risk factors of the major comorbidities of 411 workers with hemophilia enrolled in Taiwan's National Health Insurance Research Database between 1997 and 2010 with an age- and sex-matched general population.Compared with the general population, workers with hemophilia had higher risks for hemorrhagic stroke, arthritis/arthropathy, and knee/hip replacement among workers with hemophilia after multivariate adjustment, with hazard ratios (95% CI) of 4.60 (2.81-7.53), 4.03 (3.34-4.87), and 1.29 (1.10-1.41), respectively.Disorder of joints, hemophilia-related arthritis/arthropathy, hemorrhagic stroke, and knee/hip replacement remain significant comorbidities among workers with hemophilia, which will result in increased social burden. Policymakers and employers should apply appropriate interventions to help prevent productivity losses, reduced workforce participation, sick leave, and work disability among hemophilia workers.
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Affiliation(s)
- Wei-Min Chu
- Institute of Medicine, Chung Shan Medical University, Taichung
- Department of Family Medicine, Taichung Veterans General Hospital, Chiayi Branch, Chia-Yi
- School of Medicine, National Yang-Ming University, Taipei
| | - Hsin-En Ho
- Department of Family Medicine, Taichung Armed Forces General Hospital
| | - Jiaan-Der Wang
- Center for Rare Disease and Hemophilia, Department of Pediatrics, Taichung Veterans General Hospital
- School of Medicine, China Medical University, Taichung
| | - Wei-Cheng Chan
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City
| | - Yi-Sheng Liou
- School of Public Health, National Defense Medical Center, Taipei
- Department of Family Medicine, Taichung Veterans General Hospital
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Sung-Yuan Hu
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City
- Department of Nursing, College of Health, National University of Taichung Science and Technolog
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Tse Tsan
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung City
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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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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Haghpanah S, Mohtadi H, Akbari M, Karimi M. Quality of Life in Children and Adolescents With Rare Bleeding Disorders in Southern Iran. Clin Appl Thromb Hemost 2016; 23:652-656. [PMID: 26907085 DOI: 10.1177/1076029616634887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The aim of this study is to evaluate quality of life (QOL) in patients with rare bleeding disorders (RBDs). In this cross-sectional study, 52 consecutive children aged between 4 and 18 years old with RBDs registered at the Haemophila Center of Fars province in Southern Iran were investigated from January to April 2015. Quality of life was evaluated using Haemo-QOL questionnaire. Final score is defined between 0 and 100, and higher score of QOL shows worse condition. P value less than .05 was considered statistically significant. Mean age of the patients was 13.96 ± 4.50 and ranged from 4 to 18 years old including 28 males and 24 females. Family and friends were the 2 most impaired domains of Haemo-QOL in these patients. In univariate analysis, bleeding severity based on bleeding score, health status, and being bothered by the disease showed statistically significant correlations with QOL of the patients ( P < .05). In multiple linear regression models, only degree of being bothered by the disease was determined as an independent influencing factor on QOL. Taking together, Haemo-QOL of children with RBDs was better than what was reported in patients with hemophilia in our region, but it was worse than that reported in patients with hemophilia in other developing and developed countries. Due to chronic feature of bleeding disorders, more attention to different aspects of the disease, especially in 2 dimensions of family and friends through considering educational and psychological program for the patients and their family, are recommended to improve QOL of the patients with RBDs.
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Affiliation(s)
- Sezaneh Haghpanah
- 1 Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Mohtadi
- 2 Pediatric Department & Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahboobeh Akbari
- 3 Hematology Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Karimi
- 1 Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Chen CM, Huang KC, Chen CC, Huang SU, Huang CE, Chen YY, Hsu SL. The impact of joint range of motion limitations on health-related quality of life in patients with haemophilia A: a prospective study. Haemophilia 2015; 21:e176-e184. [PMID: 25684270 DOI: 10.1111/hae.12644] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2015] [Indexed: 11/29/2022]
Abstract
In patients with haemophilia A, repeated occurrences of haemarthrosis and synovitis lead to limitations in range of motion (ROM) of major joints. However, the effect of limitations in joint ROM on health-related quality of life (HRQOL) in these patients has not been studied previously. The aim of this study was to assess the impact of ROM limitations of 10 major joints (bilateral shoulders, elbows, hips, knees and ankles), combined with other possibly influential factors, on HRQOL in patients with haemophilia A. The ROM limitations in 13 movements and pain intensity of the 10 major joints were measured. The socio-demographic and clinical data were recorded. Short-Form 36 was used as the HRQOL measurement. Eighteen patients (mean age: 36.9 years) were included. Hip ROM limitations, knee ROM limitations and hip pain intensity predicted physical functioning scale (P < 0.001; adjusted R2 = 0.553). Shoulder ROM limitations and age predicted role limitation were due to emotional problems scale (P < 0.001; adjusted R2 = 0.373). Elbow ROM limitations and haemophilia severity predicted mental health scale (P = 0.001; adjusted R2 = 0.320). Hip ROM limitations predicted social functioning scale (P = 0.041; adjusted R2 = 0.091). Educational level and elbow ROM limitations predicted vitality scale (P < 0.001; adjusted R2 = 0.416). The ROM limitations of hip, knee, shoulder and elbow could be predictors for HRQOL in patients with haemophilia A. Improving ROM of major joints could be an appropriate treatment strategy to enhance HRQOL in these patients.
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Affiliation(s)
- C M Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Haemophilia and Thrombosis Treatment Center, Chang Gung Memorial Hospital, Chiayi, Taiwan
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14
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Di Michele DM, Gibb C, Lefkowitz JM, Ni Q, Gerber LM, Ganguly A. Severe and moderate haemophilia A and B in US females. Haemophilia 2014; 20:e136-43. [PMID: 24533955 DOI: 10.1111/hae.12364] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2013] [Indexed: 01/19/2023]
Abstract
Haemophilia A and B are rare X-lined hemorrhagic disorders that typically affect men. Women are usually asymptomatic carriers, but may be symptomatic and, rarely, also express severe (factor VIII (FVIII) or factor IX (FIX) <0.01 U mL(-1)) or moderately severe (FVIII/FIX 0.01-0.05 U mL(-1)) phenotypes. However, data on clinical manifestations, genotype and the psychosocial ramifications of illness in severely affected females remain anecdotal. A national multi-centre retrospective study was conducted to collect a comprehensive data set on affected US girls and women, and to compare clinical observations to previously published information on haemophilic males of comparable severity and mildly affected haemophilic females. Twenty-two severe/moderate haemophilia A/B subjects were characterized with respect to clinical manifestations and disease complications; genetic determinants of phenotypic severity; and health-related quality of life (HR-QoL). Clinical data were compared as previously indicated. Female patients were older than male patients at diagnosis, but similarly experienced joint haemorrhage, disease- and treatment-related complications and access to treatment. Gynaecological and obstetrical bleeding was unexpectedly infrequent. F8 or F9 mutations, accompanied by extremely skewed X-chromosome inactivation pattern (XIP), were primary determinants of severity. HR-QoL was diminished by arthropathy and viral infection. Using systematic case verification of participants in a national surveillance registry, this study elucidated the genetics, clinical phenotype and quality of life issues in female patients with severe/moderate haemophilia. An ongoing international case-controlled study will further evaluate these observations. Novel mechanistic questions are raised about the relationship between XIP and both age and tissue-specific FVIII and FIX expression.
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Affiliation(s)
- D M Di Michele
- Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
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15
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GOTO M, TAKEDANI H, KAWAMA K, NITTA O. Factors related to quality of life in patients with hemophilia. ACTA ACUST UNITED AC 2014. [DOI: 10.2491/jjsth.25.388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Carvalhosa AM, Henrard S, Lambert C, Hermans C. Physical and mental quality of life in adult patients with haemophilia in Belgium: the impact of financial issues. Haemophilia 2013; 20:479-85. [PMID: 24354566 DOI: 10.1111/hae.12341] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2013] [Indexed: 12/15/2022]
Abstract
In Belgium, where haemophilia affects approximately 1:7000 people (2011), data on patients' quality of life (QoL) is scarce. This project aims to assess physical and mental QoL (P-QoL and M-QoL) simultaneously, and to analyse the influence of different variables on these two aspects of QoL. After Ethics Committee approval, we contacted 84 adult haemophilia A (HA) and haemophilia B (HB) patients, without current inhibitors, on replacement therapy (on-demand or secondary prophylaxis), regularly followed up at our comprehensive treatment centre. Seventy-one (n = 59 HA, n = 12 HB) replied to our questionnaire, which included the SF36v2 QoL assessment forms. We analysed two groups of variables: one including variables previously associated with decreased QoL, and another including variables with unclear impact on QoL (e.g., patients' understanding of haemophilia-related issues, economical concerns). In our population (mean ± SD age: 45.2 ± 14.7 years old), P-QoL appeared more reduced than M-QoL. P-QoL was strongly influenced by the number of arthropathies while M-QoL was primarily affected by patients' concern of personal costs due to haemophilia. Among this latter group, having knowledge of insurance coverage had a positive impact on M-QoL. Scores did not depend on haemophilia type. QoL was impaired in our haemophilia patients. A simultaneous assessment of P-QoL and M-QoL confirmed the benefit of primary prophylaxis in P-QoL, while originally pointing out the major burden of patients' concerns and poor understanding of haemophilia-related economical issues on their M-QoL. This might become a particularly challenging issue in times of financial crisis.
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Affiliation(s)
- A M Carvalhosa
- Haemostasis and Thrombosis Unit, Division of Haematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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17
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Forsyth AL, Gregory M, Nugent D, Garrido C, Pilgaard T, Cooper DL, Iorio A. Haemophilia Experiences, Results and Opportunities (HERO) Study: survey methodology and population demographics. Haemophilia 2013; 20:44-51. [DOI: 10.1111/hae.12239] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. L. Forsyth
- RUSH Hemophilia and Thrombophilia Center; Chicago IL USA
| | | | - D. Nugent
- Children's Hospital of Orange County; Orange CA USA
| | - C. Garrido
- Asociación Venezolana para la Hemofilia; Caracas Venezuela
| | | | | | - A. Iorio
- Health Information Research Unit; Department of Clinical Epidemiology and Biostatistics, and Haemophilia Clinic; Department of Medicine; McMaster University; Hamilton ON Canada
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Cassis F, Emiliani F, Pasi J, Palareti L, Iorio A. Psychological interventions for people with hemophilia. Hippokratia 2012. [DOI: 10.1002/14651858.cd010215] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Frederica Cassis
- FMUSP; Hemophilia Centre of Hospital Das Clinicas; Umburanas street 307 San Pablo Sao Paulo Brazil 05464000
| | - Francesca Emiliani
- University of Bologna; Department of Psychology; Viale Berti Pichat 5 Bologna Italy 40127
| | - John Pasi
- BICMS Pathology Group; Academic Haematology Unit; Barts and The London School of Medicine and Dentistry 4 Newark Street London UK E1 2AT
| | - Laura Palareti
- University of Bologna; Department of Psychology; Viale Berti Pichat 5 Bologna Italy 40127
| | - Alfonso Iorio
- McMaster University; Clinical Epidemiology and Biostatistic Department; 1280 Main Street West CRL - 140 Hamilton ON Canada L8S 4K1
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LINDVALL K, Von MACKENSEN S, BERNTORP E. Quality of life in adult patients with haemophilia - a single centre experience from Sweden. Haemophilia 2012; 18:527-31. [DOI: 10.1111/j.1365-2516.2012.02765.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cassis FRMY, Querol F, Forsyth A, Iorio A. Psychosocial aspects of haemophilia: a systematic review of methodologies and findings. Haemophilia 2011; 18:e101-14. [PMID: 22059839 DOI: 10.1111/j.1365-2516.2011.02683.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Psychosocial factors have a significant impact on quality of life for patients with chronic diseases such as haemophilia. Interventions to support the psychosocial needs of patients and their families, such as offering information and assistance, clarifying doubts, and teaching coping strategies to minimize the impact of disabilities, may help to maximize patient outcomes and improve quality of life for their families. The aim of this study was to evaluate the current literature on psychosocial aspects of haemophilia. Literature searches were performed using the PubMed database to identify studies evaluating psychosocial stressors in persons with haemophilia. Articles pertaining to the HIV epidemic were excluded from the analysis, as were those published before 1997. The literature reviews identified 24 studies, covering a range of different populations, generally with small cohorts (n < 100). Most studies were questionnaire based, with almost no overlap in terms of the instruments used. Only one study combined questionnaire techniques with qualitative methods. Except for two European studies, all publications reported data from a single country. Overall, studies tended to show that quality of life is reduced in persons with haemophilia, with a potential impact on education and employment, particularly when prophylactic treatment is not available. Carrier status in women may have a psychosocial impact and affect reproductive choices. Data on psychosocial aspects of the haemophilia life cycle are lacking in the published literature, along with data from developing countries. There is a need for more international, multifaceted research to explore and quantify the social and psychological aspects of life with haemophilia.
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Affiliation(s)
- F R M Y Cassis
- Haemophilia Centre, University of São Paulo Faculty of Medicine Clinics Hospital, Sao Paulo, Brazil.
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KLAMROTH R, POLLMANN H, HERMANS C, FARADJI A, YARLAS AS, EPSTEIN JD, EWENSTEIN BM. The relative burden of haemophilia A and the impact of target joint development on health-related quality of life: results from the ADVATE Post-Authorization Safety Surveillance (PASS) study. Haemophilia 2011; 17:412-21. [DOI: 10.1111/j.1365-2516.2010.02435.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Franchini M, Mannucci PM. Co-morbidities and quality of life in elderly persons with haemophilia. Br J Haematol 2009; 148:522-33. [PMID: 19958358 DOI: 10.1111/j.1365-2141.2009.08005.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The life expectancy and quality of life of persons with haemophilia has dramatically increased since the 1970s, with the exception of the increased rate of deaths observed during the 1980s and the 1990s due to blood-borne viral infections. Improvements of factor replacement therapy, treatment of infectious diseases and comprehensive health care provided by specialised haemophilia centres are the main determinants of the increasing age of the haemophilia population. As a consequence, a growing number of these patients develop age-related co-morbidities, such as cardiovascular disease and cancer. The care of these previously rare conditions is a new challenge for caregivers in haemophilia centres. This review focuses on co-morbidities in the ageing haemophilia patients, their impact on quality of life and their complex management.
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Affiliation(s)
- Massimo Franchini
- Immunohaematology and Transfusion Centre, Department of Pathology and Laboratory Medicine, University Hospital of Parma, Italy
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MAUSER-BUNSCHOTEN EP, FRANSEN VAN DE PUTTE DE, SCHUTGENS REG. Co-morbidity in the ageing haemophilia patient: the down side of increased life expectancy. Haemophilia 2009; 15:853-63. [DOI: 10.1111/j.1365-2516.2009.01987.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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HARTL HK, REITTER S, EIDHER U, RAMSCHAK H, AY C, PABINGER I. The impact of severe haemophilia on the social status and quality of life among Austrian haemophiliacs. Haemophilia 2008; 14:703-8. [DOI: 10.1111/j.1365-2516.2008.01684.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Current World Literature. Curr Opin Obstet Gynecol 2007; 19:596-605. [DOI: 10.1097/gco.0b013e3282f37e31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barlow JH, Stapley J, Ellard DR. Living with haemophilia and von Willebrand's: a descriptive qualitative study. PATIENT EDUCATION AND COUNSELING 2007; 68:235-42. [PMID: 17904328 DOI: 10.1016/j.pec.2007.06.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 06/08/2007] [Accepted: 06/12/2007] [Indexed: 05/17/2023]
Abstract
OBJECTIVE The aim of this qualitative descriptive study was to describe the experience of living with bleeding disorders and to identify the associated salient issues from the perspectives of people living with haemophilia or von Willebrand's Disease (vWD). METHODS Nine members of The Haemophilia Society took part in a semi-structured interview. The interviews were tape recorded and transcribed and the results subjected to thematic content analysis. RESULTS Participants described the physical aspects of their condition, such as bleeding into joints, the implications of bleeds and development of co-morbid conditions (e.g. arthritis). Many felt that their bleeding disorder had impacted on their education, work, social activities and family life. Anxiety and depression were associated with daily management of symptoms, the unpredictable nature of bleeding disorders and concerns about the future. All participants had encountered a degree of stigmatisation related to their condition and felt that there was a public misconception about bleeding disorders. Many had experienced discrimination in educational and work settings. Some participants expressed a preference for seeking treatment from specialist services. CONCLUSION Living with haemophilia and vWD poses a number of daily and longer-term challenges not only for individuals, but also for their families. Further investigation of ways to support such individuals is warranted. PRACTICE IMPLICATIONS Greater awareness and understanding of the issues faced by people living with haemophilia and vWD is needed for the general public, employers, and healthcare staff, particularly those working in Accident and Emergency Departments.
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Affiliation(s)
- Julie H Barlow
- Self-Management Programme, Applied Research Centre in Health & Lifestyle Interventions, Faculty of Health & Life Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK
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