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Kempton CL, Guasch SA, Buckner TW, Mattis S, Fedewa SA. Differences and similarities in patient-reported outcomes among men and women with haemophilia. Haemophilia 2024. [PMID: 39189865 DOI: 10.1111/hae.15090] [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: 03/29/2024] [Revised: 07/09/2024] [Accepted: 07/30/2024] [Indexed: 08/28/2024]
Abstract
INTRODUCTION Both men and women can be diagnosed with haemophilia and the experience with haemophilia may be different between men and women. AIM This study aimed to compare patient-reported outcomes in men versus women with haemophilia. METHODS This cross-sectional study is a post-hoc analysis of data collected as part of the Haemophilia-related Distress Questionnaire validation study. Adults aged ≥18 years with haemophilia A or B were recruited from one of two haemophilia treatment centres between July 2017 and December 2019. Outcomes included quality of life, measures of mental and physical health, and overall health. Unadjusted and multivariable linear regression models were used to examine potential mediators of sex-based differences in outcomes. RESULTS Of the 139 study participants included (21 women, 118 men), the mean age was 36.9 years and most (89.2%) had haemophilia A. Approximately 85.7% and 26.3% of women and men had mild haemophilia, respectively. PHQ-9 depression and PROMIS-29 Profile anxiety and fatigue scores were significantly higher in women than men in unadjusted and adjusted analyses. There were no statistically significant differences in other outcomes. CONCLUSIONS Women with haemophilia are more likely to experience depression, anxiety, and fatigue than men with haemophilia. This study highlights the need for mental health services to be integrated into the care of women with haemophilia. Future research is needed to understand whether women with haemophilia are more or less likely to experience depression, anxiety, and fatigue than women without haemophilia as well as determine the impact of reduced mental health on clinical outcomes.
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Affiliation(s)
- Christine L Kempton
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sara A Guasch
- Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Tyler W Buckner
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Shanna Mattis
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Stacey A Fedewa
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia, USA
- Hemophilia of Georgia Center for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, Georgia, USA
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Ay C, Benitez-Hidalgo O, Gidley G, Mancuso ME, Matino D, Nagao A, Nemes L, Waller J, Oldenburg J. Noninterventional study assessing joint health in persons with hemophilia A after switching to turoctocog alfa pegol: design of pathfinderReal. Res Pract Thromb Haemost 2024; 8:102363. [PMID: 38572481 PMCID: PMC10987329 DOI: 10.1016/j.rpth.2024.102363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/14/2024] [Indexed: 04/05/2024] Open
Abstract
Background Joint damage affects the quality of life of persons with hemophilia A. The long-term safety and efficacy of turoctocog alfa pegol (N8-GP) prophylaxis in persons with hemophilia A has been investigated in pivotal phase 3 trials in children, adolescents, and adults (pathfinder program). However, there is a lack of data on joint health in adult persons with hemophilia A treated with N8-GP. Objectives To describe the design of the ongoing pathfinderReal study investigating the joint health status in adult persons with hemophilia A after switching to N8-GP. Methods pathfinderReal is a multicountry, noninterventional, single-arm study (NCT05621746) of joint health in adult (≥18 years) male persons with hemophilia A who have switched to N8-GP. Patients enrolled in other interventional studies and those who have previously terminated N8-GP treatment will be excluded. Approximately 124 adults with hemophilia A will be enrolled and followed up for a maximum of 24 months. Data from routine clinical assessments of patients' joint health will be collected. The primary endpoint is change in Hemophilia Joint Health Score (defined as a change in total score of ≤2) from initiation of N8-GP treatment until the end of the study. Secondary endpoints include number of bleeding episodes, number and resolution of target joints, patient-reported outcomes of problem joint score, pain score, and change in physical function levels. An exploratory endpoint is included to measure the number of patients achieving improved Hemophilia Joint Health Score from the initiation of N8-GP until the end of the study. Conclusion The pathfinderReal study will provide insights regarding the impact of N8-GP on joint health in persons with hemophilia A in a real-world setting.
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Affiliation(s)
- Cihan Ay
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Olga Benitez-Hidalgo
- Hemophilia Unit, Hematology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Gillian Gidley
- Haemophilia Comprehensive Care Centre, Department of Haematology, Leeds Teaching Hospitals Trust, Leeds, United Kingdom
| | - Maria Elisa Mancuso
- Centre for Thrombosis and Hemorrhagic Diseases, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Humanitas University, Pieve Emanuele, Milan, Italy
| | - Davide Matino
- Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Azusa Nagao
- Department of Blood Coagulation, Ogikubo Hospital, Tokyo, Japan
| | - Laszlo Nemes
- National Hemophilia Center and Hemostasis Department, Central Hospital of Northern Pest – Military Hospital, Budapest, Hungary
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Måseide RJ, Berntorp E, Astermark J, Olsson A, Bruzelius M, Frisk T, Nummi V, Lassila R, Tjønnfjord GE, Holme PA. Health-related quality of life and physical activity in Nordic patients with moderate haemophilia A and B (the MoHem study). Haemophilia 2024; 30:98-105. [PMID: 37983883 DOI: 10.1111/hae.14899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/12/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION The impact of moderate haemophilia on health-related quality of life (HRQoL) and physical activity (PA) is not well known. In previous studies, persons with factor VIII/factor IX activity (FVIII/FIX:C) below 3 IU/dL were associated with a more severe bleeding phenotype than predicted. AIM To explore HRQoL and PA in patients with moderate haemophilia A (MHA) and B (MHB). METHODS A cross-sectional, multicentre study covering patients with MHA and MHB in Sweden, Finland, and Norway. HRQoL was assessed with the EuroQoL 5-Dimensions (EQ-5D) form and PA with the International Physical Activity Questionnaire among participants aged ≥15 years. RESULTS We report on 104 patients aged 15-84 years from the MoHem study. Overall, EQ-5D utility was .85 (median) (Q1-Q3 0.73-1.0) with corresponding visual analogue scale (VAS) 80 (70-90), which were similar regardless of treatment modality, FVIII/FIX:C, and MHA or MHB. Pain and mobility were most frequently affected dimensions. Utility (r = -.54), VAS (r = -.42), and PA (r = -.32) correlated negatively with arthropathy (HJHS). Only patients aged 41-50 years displayed lower utility (p = .02) and VAS (p < .01) than the Norwegian population norm. Patients on prophylaxis aged 35-54 years reported higher PA than those treated on-demand (p = .01). CONCLUSION Haemophilic arthropathy had negative impact on HRQoL and PA in Nordic patients with moderate haemophilia. Middle-aged patients captured lower utility and VAS than observed in the general population. Tailored prophylaxis and improved joint health may influence positively on HRQoL and PA also in moderate haemophilia.
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Affiliation(s)
- Ragnhild J Måseide
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Erik Berntorp
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Jan Astermark
- Department of Translational Medicine, Lund University, Malmö, Sweden
- Department of Haematology, Skåne University Hospital, Malmö, Sweden
| | - Anna Olsson
- Department of Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Bruzelius
- Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Haematology, Karolinska University Hospital, Stockholm, Sweden
| | - Tony Frisk
- Pediatric Coagulation, Karolinska University Hospital, Stockholm, Sweden
| | - Vuokko Nummi
- Coagulation Disorders Unit, Haematology, Comprehensive Cancer Centre, Helsinki University Hospital and Research Program in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Riitta Lassila
- Coagulation Disorders Unit, Haematology, Comprehensive Cancer Centre, Helsinki University Hospital and Research Program in Systems Oncology, Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Geir E Tjønnfjord
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pål A Holme
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Oka G, Roussel-Robert V, Levivien C, Lopez I, Pieragostini R. Assessment of the clinical perception, quality of life and satisfaction of patients with severe congenital haemophilia A without inhibitor after 1 year of emicizumab therapy. Haemophilia 2023; 29:709-715. [PMID: 36748858 DOI: 10.1111/hae.14755] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/11/2023] [Accepted: 01/19/2023] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Since the approval by the EMA of emicizumab for the care of severe haemophilia A without inhibitor, most of the patients of our haemophilia treatment centre started this new treatment. Thanks to the setting of a therapeutic patient education program including three pharmaceutical consultations (PC), we could follow patients' lifestyle evolution. AIM The study aimed to assess the perceived clinical evolution, quality of life and treatment satisfaction of patients after 1 year of emicizumab therapy in real-life settings. METHODS The study was observational, retrospective and monocentric. Every patient over 18 years old receiving emicizumab from June 2020 and who underwent the 3 PC until March 2022 were included. The clinical evolution was self-estimated by patients with zero-to-six scales before versus 1 year after emicizumab, according to the following parameters: general health state, pain and bleedings (spontaneous or post-traumatic, and patients' identification ability). Patients' quality of life was also estimated with the EQ-5D-3L survey. Their satisfaction, graduated with a zero-to-ten scale, and treatment management were reported during the third PC. RESULTS Thirty-eight patients were enrolled. Their general health state improved significantly (p = .0023) with an EQ-5D-3L score at 69.6 (±19.4) out of 100. Although chronic pains remained a persistent issue for 33 (86.8%) patients, their intensity was significantly decreasing after 1 year. Perceived frequency of bleedings was significantly reduced too. On average, the satisfaction of emicizumab therapy was 9.1 (± 1.02) out of 10. CONCLUSION After 1 year of emicizumab therapy, the general health state estimated by patients improved, the pain and the perceived frequency of bleedings diminished. Overall, this treatment received a high patients' satisfaction rate.
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Affiliation(s)
- Gaëlle Oka
- Pharmacy Department, Cochin Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France
| | - Valérie Roussel-Robert
- Haemophilia Treatment Centre, Cochin Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France
| | - Clara Levivien
- Pharmacy Department, Cochin Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France
| | - Isabelle Lopez
- Pharmacy Department, Cochin Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France
| | - Rémi Pieragostini
- Pharmacy Department, Cochin Hospital (Assistance Publique - Hôpitaux de Paris), Paris, France
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van Balen EC, Haverman L, Hassan S, Taal EM, Smit C, Driessens MH, Beckers EAM, Coppens M, Eikenboom J, Hooimeijer HL, Leebeek FWG, van Vulpen LFD, Schols SEM, Terwee CB, Rosendaal FR, van der Bom JG, Gouw SC. Validation of PROMIS Profile-29 in adults with hemophilia in the Netherlands. J Thromb Haemost 2021; 19:2687-2701. [PMID: 34245088 PMCID: PMC8596807 DOI: 10.1111/jth.15454] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/19/2021] [Accepted: 07/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The Patient-Reported Outcomes Measurement Information System (PROMIS) Profile-29 questionnaire is widely used worldwide, but it has not yet been validated in the Netherlands, nor in persons with hemophilia. OBJECTIVE To validate the Dutch-Flemish version of the PROMIS-29 Profile v2.01 in adults with hemophilia. METHODS Dutch males with hemophilia (all severities) completed questionnaires that contained sociodemographic and clinical characteristics, the PROMIS-29, RAND-36, and the Hemophilia Activities List (HAL). Structural validity of each subscale was assessed with confirmatory factor analysis (CFA). Internal consistency was calculated for each subscale with sufficient model fit in CFA. Construct validity was assessed by testing hypotheses about (1) correlations of each PROMIS-29 subscale with corresponding scales of RAND-36 and domains of HAL, and (2) mean differences in T-scores between subgroups with different hemophilia severities, self-reported joint impairment, and HIV infection status. We considered ≥75% of data in accordance with the hypotheses evidence for construct validity. RESULTS In total, 770 persons with hemophilia participated in this cross-sectional study. CFA revealed sufficient structural validity for five subscales: Physical Function, Depression, Sleep Disturbance, Ability to Participate in Social Roles and Activities, and Pain Interference. Internal consistency was high and Cronbach's alpha ranged from 0.79 for Sleep Disturbance to 0.96 for Pain Interference. Differences between clinical subgroups were in the expected direction. Construct validity was confirmed for Physical Function, Anxiety, Depression, Fatigue, Sleep Disturbance, and Pain Intensity. CONCLUSION This study revealed sufficient evidence for structural validity, internal consistency, and construct validity for most PROMIS Profile-29 subscales among people with hemophilia in the Netherlands.
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Affiliation(s)
- Erna C. van Balen
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Lotte Haverman
- Child and Adolescent Psychiatry & Psychosocial CareAmsterdam Reproduction and DevelopmentAmsterdam Public HealthEmma Children’s HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Shermarke Hassan
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Elisabeth M. Taal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Cees Smit
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | | | - Erik A. M. Beckers
- Department of HematologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
| | - Jeroen Eikenboom
- Department of Internal MedicineDivision of Thrombosis and HemostasisLeiden University Medical CenterLeidenThe Netherlands
| | - Hélène L. Hooimeijer
- Department of PaediatricsUniversity Medical Center GroningenGroningenThe Netherlands
| | | | - Lize F. D. van Vulpen
- Department of Benign HematologyVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Saskia E. M. Schols
- Department of HematologyRadboud University Medical CenterNijmegenthe Netherlands
- Hemophilia Treatment Center Nijmegen‐Eindhoven‐MaastrichtNijmegenThe Netherlands
| | - Caroline B. Terwee
- Department of Epidemiology and Data ScienceAmsterdam Public Health Research InstituteAmsterdam UMCVrije Universiteit AmsterdamThe Netherlands
| | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Johanna G. van der Bom
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Clinical Transfusion ResearchSanquin Research/LUMCLeidenThe Netherlands
| | - Samantha C. Gouw
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Department of Pediatric HematologyEmma Children’s HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
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6
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Young adult outcomes of childhood prophylaxis for severe hemophilia A: results of the Joint Outcome Continuation Study. Blood Adv 2021; 4:2451-2459. [PMID: 32492157 DOI: 10.1182/bloodadvances.2019001311] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/10/2020] [Indexed: 11/20/2022] Open
Abstract
The Joint Outcome Study (JOS), a randomized controlled trial, demonstrated that children with severe hemophilia A (HA) initiating prophylactic factor VIII (FVIII) prior to age 2.5 years had reduced joint damage at age 6 years compared with those treated with episodic FVIII for bleeding. The Joint Outcome Continuation Study (JOS-C) evaluated early vs delayed prophylaxis effects on long-term joint health, following JOS participants to age 18 years in an observational, partially retrospective study. Index joint magnetic resonance imaging (MRI) scores of osteochondral (OC) damage (primary outcome), joint physical examination scores, and annualized rates of joint/other bleeding episodes (secondary outcomes) were collected. Thirty-seven of 65 JOS participants enrolled in JOS-C, including 15 randomized to prophylaxis at mean age 1.3 years ("early prophylaxis"); 18 initially randomized to episodic treatment, starting "delayed prophylaxis" at mean age 7.5 years; and 4 with high-titer inhibitors. At JOS-C exit, MRI OC damage was found in 77% of those on delayed and 35% of those on early prophylaxis for an odds ratio of OC damage, in the delayed vs early prophylaxis group, of 6.3 (95% confidence interval, 1.3, 29.9; P = .02). Annualized bleeding rates were higher with delayed prophylaxis (mean plus or minus standard deviation, 10.6 ± 6.6 vs 3.5 ± 2.1; P < .001), including when only comparing time periods on prophylaxis (6.2 ± 5.3 vs 3.3 ± 1.9; P < .05). In severe HA, early initiation of prophylaxis provided continued protection against joint damage throughout childhood compared with delayed initiation, but early prophylaxis was not sufficient to fully prevent damage. This trial was registered at www.clinicaltrials.gov as #NCT01000844.
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Mackensen S, Catalani O, Asikanius E, Paz‐Priel I, Lehle M, Trask P. Determining meaningful health‐related quality‐of‐life improvement in persons with haemophilia A using the Haemophilia Quality of Life Questionnaire for Adults (Haem‐A‐QoL). Haemophilia 2020; 26:1019-1030. [DOI: 10.1111/hae.14184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 12/28/2022]
Affiliation(s)
- Sylvia Mackensen
- Department of Medical Psychology University Medical Centre Hamburg‐Eppendorf Hamburg Germany
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Jiménez-Cebrián AM, López-López D, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Navarro-Flores E, San-Antolín M, Calvo-Lobo C, Palomo-López P. Foot health-related quality of life in hemophiliacs: A case-control study. Int J Med Sci 2020; 17:2396-2401. [PMID: 32922206 PMCID: PMC7484635 DOI: 10.7150/ijms.48705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/10/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Haemophilia is considered as a chronic genetic disease related with alteration in coagulation mechanism which affects to health related quality of life (HQoL). Purpose: The goal compared marks of HQoL, in haemophiliacs with respect non haemophilic subjects. Methods: A population of 74 subjects, were recruited from association of haemophilic illness separated in haemophilic subjects (n = 37) and no haemophilic (n = 37). For subjects who suffered haemophilia were enlisted from the association of haemophilic illness after a seminar of 45 minutes to them and to their relatives about foot health. Control subjects, were recruited from their relatives who live with the patient. The marks of the Foot Health Status Questionnaire Spanish S_FHSQ sub-scales were recompiled. Results: All S_FHSQ domains as foot pain, foot function, tootwear, general foot health, general health, physical activity and social capacity showed lower scores in the haemophilic than non-haemophilic group (P <0.01) except for vigour (P = 0.173). Regarding the rest sub-scale marks of S_FHSQ, showed no significant difference P <0.01. Conclusion: Subjects with a haemophilia showed significant worse foot QoL in all S_FHSQ domains except vigour domain compared with non-haemophilic subjects.
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Affiliation(s)
- Ana María Jiménez-Cebrián
- Department Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, c/ Arquitecto Francisco Peñalosa 3, Ampliación del Campus de Teatinos, 29071 Málaga, Spain, Instituto de Investigación Biomédica de Málaga (IBIMA) https://orcid.org/000-0002-8634-7114
| | - Daniel López-López
- Research, Health and Podiatry Group. Department of Health Sciences, Faculty of Nursing and Podiatry. Universidade da Coruña, Ferrol, Spain
| | | | | | - Emmanuel Navarro-Flores
- Faculty of Nursing and Podiatry, Department of Nursing. University of Valencia. Frailty Research Organizaded Group (FROG)
| | - Marta San-Antolín
- Department of Psychology, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
| | - César Calvo-Lobo
- Facultad de Enfermería, Fisioterapia y Podología. Universidad Complutense de Madrid, Spain
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Lambert C, Meité N, Sanogo I, Lobet S, von Mackensen S, Hermans C. Cross-cultural adaptation and validation of Haem-A-QoL in Côte d'Ivoire. Haemophilia 2020; 26:459-466. [PMID: 32394627 DOI: 10.1111/hae.13987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/10/2020] [Accepted: 03/16/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Health-related quality (HRQoL) evaluations are considered essential outcomes in the assessment of people with haemophilia. In developing countries, reliable HRQoL data are even more critical whilst enabling government agencies to develop national haemophilia care programmes. However, validated tools are not yet available in sub-Saharan African countries. AIMS This study sought to perform a cultural adaptation and validation of the Haemophilia Quality of Life Questionnaire for Adults (Haem-A-QoL) in Côte d'Ivoire. METHODS The process comprised several steps, such as linguistic adaptation, cognitive debriefing interviews with adult haemophilia patients and psychometric testing, including reliability (internal consistency, test-retest reliability) and validity assessments (convergent with EQ-5D-5L, criterion with HJHS 2.1, known-groups). RESULTS The final Ivoirian Haem-A-QoL version was obtained in December 2017 following linguistic adaptation and cognitive debriefings with six participants. The validation process included 25 patients, mainly haemophilia A patients (88%) with severe forms (80%). All participants received on-demand treatment, with joint impairment observed in 92%. Internal consistency and test-retest reliability of the Ivoirian Haem-A-QoL were very good. A Pearson correlation analysis revealed a moderate negative correlation between EQ-VAS and total Haem-A-QoL scores and a moderate positive correlation between HJHS 2.1 and total Haem-A-QoL scores. CONCLUSIONS A cross-culturally adapted and validated Haem-A-QoL version in Côte d'Ivoire is now available, enabling measurement of intervention outcomes in the targeted population and Ivorian participation to multisite international trials. However, further work is needed to ensure optimal understanding of HRQoL questionnaires, previously developed in culturally distinct countries, with almost unlimited access to different treatment regimens.
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Affiliation(s)
- Catherine Lambert
- Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - N'Dogomo Meité
- Division of Clinical Hematology, Centre Hospitalier Universitaire de Yopougon, Abidjan, Ivory Coast
| | - Ibrahima Sanogo
- Division of Clinical Hematology, Centre Hospitalier Universitaire de Yopougon, Abidjan, Ivory Coast
| | - Sébastien Lobet
- Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Division of Physical Medicine and Rehabilitation, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal Lab, Université Catholique de Louvain, Brussels, Belgium
| | - Sylvia von Mackensen
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Cedric Hermans
- Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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10
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Manzar MD, Salahuddin M, Khan TA, Shah SA, Mohammad NS, Nureye D, Addo HA, Jifar WW, Albougami A. Psychometric Properties of a Brief Metamemory and Metaconcentration Scale in Substance Use Problem. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00256-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Buckner TW, Sidonio R, Witkop M, Guelcher C, Cutter S, Iyer NN, Cooper DL. Correlations between patient-reported outcomes and self-reported characteristics in adults with hemophilia B and caregivers of children with hemophilia B: analysis of the B-HERO-S study. PATIENT-RELATED OUTCOME MEASURES 2019; 10:299-314. [PMID: 31572035 PMCID: PMC6755243 DOI: 10.2147/prom.s219166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 08/19/2019] [Indexed: 02/05/2023]
Abstract
Purpose Pain, anxiety, depression, and other aspects of health-related quality of life (HRQoL) are important issues for people with hemophilia and caregivers of children with hemophilia. Patient-reported outcome (PRO) instruments may be used to assess aspects of HRQoL; however, the use of PROs in clinical management of patients with hemophilia is limited and inconsistent. The Bridging Hemophilia B Experiences, Results and Opportunities Into Solutions (B-HERO-S) study evaluated the impact of hemophilia B on HRQoL and other psychosocial aspects in affected adults and caregivers of children with hemophilia B. This post hoc analysis assessed correlations between PRO scores and psychosocial questions commonly asked in comprehensive care settings among B-HERO-S respondents. Patients and methods B-HERO-S consisted of two online surveys, one administered to adults with hemophilia B (n=299) and one administered to caregivers of children with hemophilia B (n=150). The adult survey included EQ-5D-5L with visual analog scale, BPI, HAL, and PHQ-9. The caregiver survey included PHQ-9 and GAD-7. Questions related to demographics, hemophilia treatment, and psychosocial questions asked in comprehensive care visits were also included in the surveys. A post hoc analysis was performed to assess correlations between responses to selected psychosocial questions with PRO scores. Results For adults with hemophilia B, greater pain severity and pain interference scores were associated with work-related problems, functional limitations, and relationship, psychological, and treatment issues. Significant correlations were also noted between some of these psychosocial outcomes and depressive symptoms. For caregivers, greater depression and anxiety were associated with employment issues, their child’s functional, relationship, and psychological issues, having had difficulty or concerns with treatment/factor availability or affordability, and having less frequent HTC visits. Conclusion High correlations were observed between PRO scores measuring pain, depression, and anxiety and questions commonly used in the comprehensive care setting to assess the psychosocial impact of hemophilia.
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Affiliation(s)
- Tyler W Buckner
- Hemophilia and Thrombosis Center, University of Colorado School of Medicine, Aurora, CO, USA
| | - Robert Sidonio
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Emory University and Children's Healthcare of Atlanta, Atlanta, GA, USA
| | | | - Christine Guelcher
- Hemostasis and Thrombosis Program, Center for Cancer and Blood Disorders, Children's National Health System, Washington, DC, USA
| | - Susan Cutter
- Penn Comprehensive Hemophilia and Thrombosis Center, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Lobet S, Meité N, Koninckx MI, Van Overstraeten A, Kamagate AM, Hermans C, Lambert C. Implementation and assessment of a self- and community-based rehabilitation programme in patients with haemophilia from Côte d'Ivoire. Haemophilia 2019; 25:859-866. [PMID: 31393670 DOI: 10.1111/hae.13833] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/04/2019] [Accepted: 07/15/2019] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In resource-constrained countries, few patients with haemophilia (PWH) have access to clotting factor concentrates (CFC), with increased musculoskeletal (MSK) complications. Physiotherapy actively contributes to preventing MSK complications, minimizing joint damage and reducing pain. AIM To assess the impact of a 20-week self- and community-based rehabilitation (CBR) programme in Ivorian PWH. METHODS Fifty participants underwent a clinical and functional baseline assessment with identification of joints' functional defects and initiation of an individualized exercise programme comprising exercises to improve strength, joint mobility and proprioception. Hemophilia Joint Health Score (HJHS), 2-minute walking test (2MWT), Timed Up and Go (TUG), goniometry and maximal isometric voluntary contractions using the MicroFET2 were performed at baseline (T1) and at Week 20 (T2). RESULTS At T2, there was a significant improvement in both the 2MWT and TUG tests. The HJHS total score decreased significantly from 23.6 ± 14.2 at T1 to 20.4 ± 13 at T2. A significant improvement in joint health was found in the left elbow, right knee and right ankle, with elements correlating with joint function responsible for these improvements. A strong programme adherence was observed, with 94% of participants reporting regular exercise performance and a high degree of satisfaction. CONCLUSION The programme with its encouraging results is meant to be the first step towards a more ambitious project. Self-based and CBR programmes are inexpensive and efficient treatment options designed to minimize the detrimental effects of joint and muscle bleedings, and to increase the functional independence and quality of life of PWH with limited access to CFC and physiotherapy.
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Affiliation(s)
- Sébastien Lobet
- Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal Lab, Université Catholique de Louvain, Bruxelles, Belgium.,Department of Physical medicine and rehabilitation, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.,Hemostasis and Thrombosis Unit, Department of Hematology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - N'Dogomo Meité
- Department of Clinical hematology, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Marie-Inès Koninckx
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Antoine Van Overstraeten
- Faculté des Sciences de la Motricité, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Amed Mama Kamagate
- Department of Physical medicine and rehabilitation, Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
| | - Cédric Hermans
- Hemostasis and Thrombosis Unit, Department of Hematology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Catherine Lambert
- Hemostasis and Thrombosis Unit, Department of Hematology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
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Lambert C, Meité N, Sanogo I, Lobet S, Adjambri E, Eeckhoudt S, Hermans C. Haemophilia in Côte d’Ivoire (the Ivory Coast) in 2017: Extensive data collection as part of the World Federation of Hemophilia’s twinning programme. Haemophilia 2019; 25:236-243. [DOI: 10.1111/hae.13682] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/29/2018] [Accepted: 12/18/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Catherine Lambert
- Hemostasis and Thrombosis Unit, Division of Hematology Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - N’Dogomo Meité
- Division of Clinical Hematology Centre Hospitalier Universitaire de Yopougon Abidjan Côte d’Ivoire
| | - Ibrahima Sanogo
- Division of Clinical Hematology Centre Hospitalier Universitaire de Yopougon Abidjan Côte d’Ivoire
| | - Sébastien Lobet
- Hemostasis and Thrombosis Unit, Division of Hematology Cliniques Universitaires Saint‐Luc Brussels Belgium
- Division of Physical Medicine and Rehabilitation Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Eusèbe Adjambri
- Hematology Unit of the Central Laboratory Centre Hospitalier Universitaire de Yopougon Abidjan Côte d’Ivoire
| | - Stéphane Eeckhoudt
- Hemostasis and Thrombosis Laboratory, Division of Biological Chemistry Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Cedric Hermans
- Hemostasis and Thrombosis Unit, Division of Hematology Cliniques Universitaires Saint‐Luc Brussels Belgium
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Buckner TW, Sidonio R, Guelcher C, Kessler CM, Witkop M, Clark D, Owens W, Fridman M, Iyer NN, Cooper DL. Reliability and validity of patient-reported outcome instruments in US adults with hemophilia B and caregivers in the B-HERO-S study. Eur J Haematol 2018; 101:781-790. [PMID: 30179272 DOI: 10.1111/ejh.13168] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To assess the reliability and validity of six patient-reported outcomes (PRO) instruments for evaluating health-related quality of life in adults with mild-severe hemophilia B and caregivers of children with hemophilia B, including affected women/girls. METHODS Adults with hemophilia B and caregivers completed separate online surveys containing several PRO instruments, which were administered to adult participants only (EQ-5D-5L, Brief Pain Inventory v2 Short Form, Hemophilia Activities List, and International Physical Activities Questionnaire), both adults and caregivers (Patient Health Questionnaire [PHQ-9]), or caregivers only (Generalized Anxiety Disorder 7-Item [GAD-7] scale). Construct validity and item-total correlation were assessed using Pearson product-moment correlation, internal consistency was assessed using Cronbach's alpha coefficient, and known-group validity was assessed by comparisons to self-reported characteristics based on the Kruskal-Wallis test. RESULTS Patient-reported outcomes instruments generally showed satisfactory reliability for adults (n = 299) and caregivers (n = 150). In adults, PRO instruments generally showed high construct validity. Most PRO instruments showed expected significant differences among known groups for adults and caregivers. PHQ-9 and GAD-7 did not show significant differences among caregiver age groups. CONCLUSIONS Patient-reported outcomes instruments administered in B-HERO-S demonstrated reliability and validity in the broader population of adults with hemophilia B and caregivers when including all severities and genders.
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Affiliation(s)
| | | | | | - Craig M Kessler
- Georgetown University Hospital, Washington, District of Columbia
| | | | - David Clark
- The Coalition for Hemophilia B, New York, New York
| | - Wendy Owens
- Hemophilia Federation of America, Washington, District of Columbia
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15
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Batt K, Boggio L, Neff A, Buckner TW, Wang M, Quon D, Witkop M, Recht M, Kessler C, Iyer NN, Cooper DL. Patient-reported outcomes and joint status across subgroups of US adults with hemophilia with varying characteristics: Results from the Pain, Functional Impairment, and Quality of Life (P-FiQ) study. Eur J Haematol 2018; 100 Suppl 1:14-24. [PMID: 29498783 DOI: 10.1111/ejh.13028] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Pain and functional impairment associated with joint disease are major problems for people with hemophilia, and impact on health-related quality of life (HRQoL) may vary across groups defined by demographic and treatment-related characteristics. OBJECTIVE To evaluate differences in overall HRQoL, pain, function, and joint status between P-FiQ study subgroups. METHODS Adult males with hemophilia and a history of joint pain/bleeding completed a pain history and the patient-reported outcome instruments EQ-5D-5L, Brief Pain Inventory v2 Short Form (BPI), International Physical Activity Questionnaire (IPAQ), and Hemophilia Activities List (HAL); optionally, joint status was assessed (Hemophilia Joint Health Score v2.1 [HJHS]). Scores were analyzed between subgroups across sets of participant characteristics. RESULTS A total of 381 adult males with hemophilia were enrolled, with median age of 34 years. Worse scores on EQ-5D-5L index, BPI pain severity/interference, HAL overall score, and HJHS were generally associated with being college educated, unemployment, self-reporting both acute and chronic pain, and self-reporting anxiety/depression. CONCLUSIONS Measures of joint status and HRQoL were consistently lower in participants who had higher educational levels, were unemployed, self-reported having both acute and chronic pain, and self-reported having anxiety/depression. A greater understanding of the association of these factors with disease outcomes may improve individualized patient management.
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Affiliation(s)
| | - Lisa Boggio
- Rush University Medical Center, Chicago, IL, USA
| | - Anne Neff
- Cleveland Clinic, Cleveland, OH, USA
| | | | - Michael Wang
- University of Colorado School of Medicine, Aurora, CO, USA
| | - Doris Quon
- Orthopaedic Hemophilia Treatment Center, Orthopaedic Institute for Children, Los Angeles, CA, USA
| | | | - Michael Recht
- Oregon Health & Science University, Portland, OR, USA
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Buckner TW, Batt K, Cooper DL, Kempton CL. What can we learn from using formal patient-reported outcome instruments to assess pain, functional impairment, anxiety, and depression in US adults with hemophilia? Eur J Haematol 2018; 100 Suppl 1:3-4. [PMID: 29498785 DOI: 10.1111/ejh.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/27/2022]
Abstract
People with hemophilia frequently suffer from arthropathy that leads to pain and functional impairment, ultimately resulting in reduced quality of life. The impact of pain and functional impairment on the lives of people with hemophilia was explored in the Pain, Functional Impairment, and Quality of Life (P-FiQ) study. Various patient-reported outcome (PRO) instruments were employed to assess the effect of pain and functional impairment on multiple aspects of health in people with hemophilia. The results presented in this supplement include detailed observations from PRO instruments regarding pain, functional impairment, anxiety, and depression, an analysis of the differences in health-related quality of life across subgroups of patients defined by demographic and treatment-related characteristics, and results of a modeling analysis to identify patient factors which influence perceptions of pain and functional impairment, independent of joint status. These data provide insights into how the results from PRO assessments may be used to evaluate outcomes for people with hemophilia in the clinical and research settings.
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Kempton CL, Buckner TW, Fridman M, Iyer NN, Cooper DL. Factors associated with pain severity, pain interference, and perception of functional abilities independent of joint status in US adults with hemophilia: Multivariable analysis of the Pain, Functional Impairment, and Quality of Life (P-FiQ) study. Eur J Haematol 2018; 100 Suppl 1:25-33. [DOI: 10.1111/ejh.13025] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 01/31/2023]
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18
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Buckner TW, Batt K, Quon D, Witkop M, Recht M, Kessler C, Baumann K, Hernandez G, Wang M, Cooper DL, Kempton CL. Assessments of pain, functional impairment, anxiety, and depression in US adults with hemophilia across patient-reported outcome instruments in the Pain, Functional Impairment, and Quality of Life (P-FiQ) study. Eur J Haematol 2018; 100 Suppl 1:5-13. [DOI: 10.1111/ejh.13027] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Doris Quon
- Orthopaedic Hemophilia Treatment Center; Orthopaedic Institute for Children; Los Angeles CA USA
| | | | | | | | - Kimberly Baumann
- Center for Bleeding and Clotting Disorders; University of Minnesota Health; Minneapolis MN USA
| | - Grace Hernandez
- Center for Comprehensive Care and Diagnosis of Inherited Bleeding Disorders; Orange CA USA
| | - Michael Wang
- University of Colorado School of Medicine; Aurora CO USA
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Kempton CL, Recht M, Neff A, Wang M, Buckner TW, Soni A, Quon D, Witkop M, Boggio L, Gut RZ, Cooper DL. Impact of pain and functional impairment in US adults with haemophilia: Patient-reported outcomes and musculoskeletal evaluation in the pain, functional impairment and quality of life (P-FiQ) study. Haemophilia 2017; 24:261-270. [DOI: 10.1111/hae.13377] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2017] [Indexed: 01/19/2023]
Affiliation(s)
| | - M. Recht
- Oregon Health & Science University; Portland OR USA
| | - A. Neff
- Cleveland Clinic; Cleveland OH USA
| | - M. Wang
- University of Colorado School of Medicine; Aurora CO USA
| | - T. W. Buckner
- University of Colorado School of Medicine; Aurora CO USA
| | - A. Soni
- Center for Inherited Blood Disorders; CHOC Children's Hospital/UC Irvine; Orange CA USA
| | - D. Quon
- Orthopaedic Hemophilia Treatment Center; Orthopaedic Institute for Children; Los Angeles CA USA
| | - M. Witkop
- Munson Medical Center; Traverse City MI USA
| | - L. Boggio
- Rush University Medical Center; Chicago IL USA
| | - R. Z. Gut
- Novo Nordisk Inc.; Plainsboro NJ USA
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