Barriers and challenges for the fast treatment of bleeds in the non‐haemophilia treatment centre hospital setting. Issue 3 (9th March 2020)

• Record Type: Journal Article
• Authors: de Moerloose, Philippe; Davis, Joanna A.; Benchikh El Fegoun, Soraya; Habis, Richard; Klamroth, Robert
• Is Part Of: Haemophilia. Volume 26:Issue 3(2020)
• Page Start: 422
• Page End: 430
• Publication Date: 2020-03-09
• Subjects: bypassing agent -- delay -- education -- haemophilia -- non‐haemophilia treatment centre -- treatment; Hemophilia -- Periodicals; 616.1572005
• DOI: 10.1111/hae.13956
• Languages: English
• ISSNs: 1351-8216

Abstract

Abstract: Introduction: Early treatment for acute bleeds in patients with haemophilia and inhibitors is feasible when patients are managed in haemophilia treatment centres (HTCs). Patients may need to attend non‐HTCs for out‐of‐hours emergency care, especially if HTCs are not local and/or transport is difficult. Aim: We evaluated the barriers to the fast treatment of bleeds in patients with haemophilia and inhibitors presenting at non‐HTCs. Methods: Healthcare professionals (HCPs) from non‐HTCs in the United States (n = 218) and Germany (n = 98) were selected from validated online panels and invited to participate in a survey (October‐November 2017). Results: A mean of 6 (US) and 5 (German) patients with haemophilia and inhibitors were managed for bleeds by these HCPs over 12 months; patient characteristics were similar in both countries. The main HCPs involved in treating bleeds were emergency room specialists (94%) and haematologists (91%) (US); haematologists (79%) and anaesthesiologists (59%) (Germany). Only 26% (US) and 28% (Germany) of HCPs had access to treatment guidelines for these patients; access to bypassing agents was similarly limited: 44% (US) and 38% (Germany) of HCPs reported their institution did not stock these agents. In both countries, key reasons for delaying treatment were lack of bypassing agent availability, HCP experience/education of bleed disorders and internal process time. Conclusion: Barriers to fast treatment of bleeds in patients with haemophilia and inhibitors were identified in non‐HTCs in the United States and Germany. These could be reduced by improving the availability of treatment guidelines, bypassing agents and HCP education/training.