Home Treatment of Haemophilia a Follow‐up Study

Ekert, H.; Moorehead, Michelle; Williamson, Graham

doi:10.5694/j.1326-5377.1981.tb132049.x

Cited by 13 publications

(13 citation statements)

References 11 publications

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“…We reanalyzed the data from 6420 participants and found a risk ratio of 1.01 (95% CI, 0.75–1.36) (Table ). Seven unique non‐comparative studies (which were reported in twelve published articles) reported a range of results with some reporting low rates in absenteeism, but others reporting greater than 15 missed days per year (Appendix S3). Overall, there was very low‐quality evidence for a reduction in missed days of work or school per year of approximately 10 days.…”

Section: Resultsmentioning

confidence: 99%

Care models in the management of haemophilia: a systematic review

et al. 2016

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Background Haemophilia care is commonly provided via multidisciplinary specialized management. To date, there has been no systematic assessment of the impact of haemophilia care delivery models on patient-important outcomes. Objective To conduct a systematic review of published studies assessing the effects of the integrated care model for persons with haemophilia (PWH). Search methods We searched MEDLINE, EMBASE and CINAHL up to April 22, 2015, contacted experts in the field, and reviewed reference lists. Selection criteria Randomized and non-randomized studies of PWH or carriers, focusing mainly on the assessment of care models on delivery. Data collection and analysis Two investigators independently screened title, abstract, and full text of retrieved articles for inclusion. Risk of bias and overall quality of evidence was assessed using Cochrane’s ACROBAT-NRSI tool and GRADE respectively. Relative risks, mean differences, proportions, and means and their variability were calculated as appropriate. Results 27 non-randomized studies were included: eight comparative and 19 non-comparative studies. We found low- to very low-quality evidence that in comparison to other models of care, integrated care may reduce mortality, hospitalizations and emergency room visits, may lead to fewer missed days of school and work, and may increase knowledge seeking. Conclusion Our comprehensive review found low- to very low-quality evidence from a limited number of non-randomized studies assessing the impact of haemophilia care models on some patient-important outcomes. While the available evidence suggests that adoption of the integrated care model may provide benefit to PWH, further high-quality research in the field is needed.

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Section: Resultsmentioning

confidence: 99%

Care models in the management of haemophilia: a systematic review

et al. 2016

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“…ROM has been the most commonly used physical outcome measure for evaluating the effects of intervention on joint health [11,12]. ROM has been the most commonly used physical outcome measure for evaluating the effects of intervention on joint health [11,12].…”

Section: Physical Examination Scoresmentioning

confidence: 99%

Outcome Assessment in Hemophilia

Poonnoose

Srivastava

2014

Textbook of Hemophilia

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“…Aronstam et al reported that resolution of joint haemorrhage was not dependent upon factor replacement dose in normal joints but required higher dosing in target joints [10]. Ekert et al reported on a 5-year observational study in which one-third of 24 children treated for haemarthroses with a single infusion of factor VIII (FVIII) at 20 U kg )1 developed decreased range of motion, implying that this dosage was inadequate for prevention and/or that children are at increased risk of joint damage [17]. Brettler et al conducted a similar 6-year observational study of 64 children and adults treated with a slightly higher dose of FVIII (25 U kg )1 ) and liberal use of repeat infusions at 24 h [18].…”

Section: Background Data On Development Of Optimal Haemophilia Therapiesmentioning

confidence: 99%

North American prophylaxis studies for persons with severe haemophilia: background, rationale and design

Manco‐Johnson

Blanchette

2003

Haemophilia

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Arthropathy is associated with the greatest cost and morbidity to persons with haemophilia. Clinical protocols have been developed empirically to prevent or retard the development of joint disease using routine infusions of replacement factor concentrate. However, randomized clinical trials to determine optimal therapy to prevent joint disease in persons with severe haemophilia are lacking. Two clinical trials are ongoing to answer important clinical questions about the prevention of arthropathy. The first, a US randomized clinical trial, is comparing an aggressive multiple-infusion episode-based protocol to standard alternate-day prophylaxis to determine whether prevention of joint disease requires prevention of the bleeding event, per se, or can be achieved by promoting complete resolution of each bleeding event in the joint. This study included the development and validation of sensitive new physical and imaging scales to detect the earliest signs of joint disease in young children. The second, a single-arm, open-label Canadian study, is asking whether prevention of joint disease in young children can be individualized by escalating the dose and frequency of routine replacement infusions of factor concentrate based upon the clinical course of haemophilia in the affected child. Both of these studies will contribute valuable information regarding optimal therapy and will help establish evidence-based medicine for the management of severe haemophilia.

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Home Treatment of Haemophilia a Follow‐up Study

Cited by 13 publications

References 11 publications

Care models in the management of haemophilia: a systematic review

Care models in the management of haemophilia: a systematic review

Outcome Assessment in Hemophilia

North American prophylaxis studies for persons with severe haemophilia: background, rationale and design

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