Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US haemophilia treatment centre professionals

Abstract

Background: Despite the high prevalence of overweight and obesity in the United States, few studies have assessed the impact of obesity on haemophilia-specific outcomes or experiences/perceptions of healthcare providers (HCPs) treating haemophilia. Aim: The Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION-TO-HOPE) study was designed to identify HCP insights on the unique challenges of patients with haemophilia and obesity/overweight (PwHO) and the barriers to chronic weight management. Methods: An online survey collected data from haemophilia treatment centre-based HCPs. Respondents included 10 adults and 29 paediatric haematologists, 27 nurses/ nurse practitioners/physician assistants, 22 physical therapists and 17 social workers.Results: Almost all HCPs rated obesity of moderate/high concern and reported that weight significantly affects future health and has an impact on life expectancy, yet fewer than 60% reported discussing the impact of weight on health with their patients. HCPs reported that few PwHO tried to lose weight; not many were 'successful'. HCPs perceived a desire to feel better physically and joint pain as top motivating factors. HCPs believe that PwHO would have less joint bleeding and pain and greater mobility if they lost weight. HCPs viewed lack of exercise and food preferences/habits as the biggest barriers to initiating/maintaining weight loss and therefore recommended increasing exercise and healthier eating to their patients. However, physical activity in this patient population is limited and requires advice and support.Conclusions: Most HCPs appreciated the impact of obesity on joint bleeding, pain, and function and quality of life. Reduced food intake and increased activity are the most commonly recommended weight-loss strategies but the least likely to be successful. HCPs desire additional education/materials to understand weight management for PwHO. | 21WANG et Al.

Optimizing factor VIII dosing in obese individuals with haemophilia A

“…Although this has been our observation, a recent report from the Centers for Disease Control has estimated that nationwide two-thirds of adults with haemophilia A are either overweight (33.8%) or obese (32.8%) [2]. This issue was highlighted by several recent studies showing that patients, caregivers and healthcare providers were concerned about obesity and haemophilia, but were unsure about how to best address the problem [3–5]. The progressive epidemic of obesity, in addition to the skyrocketing costs of healthcare, underscores the need for contemporary pharmacokinetic studies to optimize dosing of FVIII in obese individuals with haemophilia A in the modern era.…”