Adherence with haemophilia treatments: a survey of haemophilia healthcare professionals in Canada

Chan, Anthony; Decker, K.; Warner, Margaret R.

doi:10.1111/j.1365-2516.2011.02502.x

Cited by 4 publications

(6 citation statements)

References 3 publications

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“…These data are similar to those of Chan et al. where 50% of physicians in Canada indicated children were 80–100% adherent and 19% indicated adolescents were 80–100% adherent [20]. Adolescence and transition to adulthood may be a significant barrier to adherence with prophylaxis and clinicians have identified poor adherence by adolescents as a reason not to prescribe prophylaxis to that group.…”

Section: Discussionsupporting

confidence: 85%

“…Although there is a newly validated measure of adherence with prophylaxis (VERITAS‐Pro) [19] this measure has not been widely adopted in clinical practice. In response to a survey of Canadian haematologists and nurses, 12.5% of physicians and 17.6% of nurses indicated that they do not assess adherence [20]. Based on the adherence measures, only 42% of respondents reported that >75% of their patients have excellent adherence (≥80% of prescribed doses) with prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

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Current prescription of prophylactic factor infusions and perceived adherence for children and adolescents with haemophilia: a survey of haemophilia healthcare professionals in the United States

et al. 2012

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The primary goal of prophylaxis in patients with severe haemophilia is to convert the phenotype from severe to moderate and to prevent the development of chronic arthropathy. Prior studies have demonstrated that prophylaxis decreases episodes of joint bleeds and chronic arthropathy. Effectiveness depends on prescription of prophylaxis and adherence to the prescribed regimen. The aim of this study was to determine if prescription of prophylaxis for children with haemophilia and perceptions of adherence to prophylaxis have changed since publication of the Joint Outcome Study (JOS). A questionnaire was sent, in electronic and written formats, to health professionals who provide care to children with haemophilia at US haemophilia treatment centres (HTCs). The response rate was 56 of 128 (44%) of the targeted HTCs. There were a few missing data and denominators are provided. All responses agreed with the results of the JOS and 30/55 (55%) reported the JOS increased their prescription of prophylaxis. Nineteen of 56 (34%) physicians or HTC staff reported that they had not prescribed prophylaxis within the last year due to concerns about adherence, and 19/56 (34%) reported they had stopped prophylaxis due to concerns about adherence within the last year. Predicted adherence decreased with increasing age. Prescription of prophylaxis appears to be increasing since publication of the JOS. Strategies to improve adherence may increase the likelihood of physician prescription of prophylaxis and make prophylaxis easier to implement for individual patients, thereby improving the clinical outcome of children and adults with haemophilia.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Current prescription of prophylactic factor infusions and perceived adherence for children and adolescents with haemophilia: a survey of haemophilia healthcare professionals in the United States

et al. 2012

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“…The adherence rate to prophylactic factor concentrate regimens in adults with haemophilia has only recently been examined in Canada. In a recent survey of 35 haematologists and 17 nurses across Canada, health care professionals' assessment of adherence to treatment in adults with haemophilia was rated as good to excellent (80–100%) in only one third of patients . Furthermore, nearly 18% of haemophilia health care professionals did not routinely assess for adherence rates.…”

Section: Discussionmentioning

confidence: 99%

An objective method for assessing adherence to prophylaxis in adults with severe haemophilia

Gue

McIntosh

et al. 2013

Haemophilia

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Severe haemophilia is often managed by prophylactic factor infusions in developed countries. The benefits of secondary prophylaxis in adults are currently being studied and adherence to the prescribed prophylactic factor regimen is vital to decreasing bleeding episodes. The aim of this study was to measure discrepancy between the physicians' prescription for prophylactic factor usage, and the actual factor usage obtained through infusion logs. During this method subjects with severe haemophilia A or B (FVIII or FIX ≤2%), from a single haemophilia clinic with complete medical and infusion records from July 01, 2009 to June 30, 2011, were evaluated. Continuous prophylaxis ≥4 weeks were included in the analysis. A scoring system for adherence to prescribed dosing and frequency was developed. A global scale of adherence was performed by two independent nurses using visual analogue scale. Thirty-one subjects, all with haemophilia A, with a median age of 26 years (range 18-56) were included. Results showed that the median (IQR) adherence rate to prescribed frequency and dosage, respectively, was 76% (67;85) and 93% (73;97). In multivariate analysis, only the length of time on prophylaxis during the study period showed a positive correlation with adherence whereas age, number of co-infections, number of bleeds and number of joints with chronic arthropathy did not. Global nursing assessments were in general agreement with the score. In conclusion, we observed a moderately good level of adherence based on score and by the nurse global assessment. Better adherence was found in subjects with longer exposure to prophylaxis.

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“…In a study of nurse-reported data, Geraghty et al found levels of adherence of 90% in patients aged 0-12 years, 54% in patients aged 13-18, and 36% in patients aged 19-28 years [27] . A Canadian survey suggests that paediatric patients have higher levels of adherence than adolescents or adults [28,29] . Increasing age is also associated with lower levels of adherence [23] .…”

Section: Explanatory Variablesmentioning

confidence: 99%

Predictors of treatment adherence in patients with chronic disease using the Multidimensional Adherence Model: unique considerations for patients with haemophilia

Strike

Chan

Iorio

et al. 2020

The Journal of Haemophilia Practice

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IntroductionAdherence to treatment recommendations in patients with chronic disease is complex and is influenced by numerous factors. Haemophilia is a chronic disease with reported levels of adherence ranging from 17–82%.AimBased on the theoretical foundation of the World Health Organization Multidimensional Adherence Model, the objective of this study was to identify the best combination of the variables infusion frequency, annualised bleed rate, age, distance to haemophilia treatment centre (HTC) and Haemophilia Joint Health Score (HJHS), to predict adherence to treatment recommendations in patients with haemophilia A and B on home infusion prophylaxis in Canada.MethodsA one-year retrospective cohort study investigated adherence to treatment recommendations using two measures: 1) subjective report via home infusion diaries, and 2) objective report of inventory ordered from Canadian Blood Services. Stepwise regression was performed for both measures.ResultsEighty-seven patients with haemophilia A and B, median age 21 years, were included. Adherence for both measures was 81% and 93% respectively. The sample consisted largely of patients performing an infusion frequency of every other day (34%). Median scores on the HJHS was 10.5; annualised bleed rate was two. Distance to the HTC was 51km. Analysis of the objective measure weakly supported greater infusion frequency as a treatment-related factor for the prediction of lower adherence, however the strength of this relationship was not clinically relevant (R2=0.048). For the subjective measure, none of the explanatory variables were significant.ConclusionAdherence is a multifaceted construct. Despite the use of theory, most of the variance in adherence to treatment recommendations in this sample of patients with haemophilia remains unknown. Further research on other potential predictors of adherence, and possible variables and relationships within factors of the MAM is required.

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Adherence with haemophilia treatments: a survey of haemophilia healthcare professionals in Canada

Cited by 4 publications

References 3 publications

Current prescription of prophylactic factor infusions and perceived adherence for children and adolescents with haemophilia: a survey of haemophilia healthcare professionals in the United States

Current prescription of prophylactic factor infusions and perceived adherence for children and adolescents with haemophilia: a survey of haemophilia healthcare professionals in the United States

An objective method for assessing adherence to prophylaxis in adults with severe haemophilia

Predictors of treatment adherence in patients with chronic disease using the Multidimensional Adherence Model: unique considerations for patients with haemophilia

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