Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent?

Abstract

OBJECTIVES: To assess how many hospital visits primary prophylaxis with clotting factor could prevent. DESIGN: The potential for reducing hospital visits was assessed by comparing rates of in-patient, Out-patient and day-case visits per patient-year for individuals with severe (< 1 IU dL-1) haemophilia who had never received primary prophylaxis with attendance rates for individuals with mild/moderate (1-50 IU dL-1) haemophilia. Hospital attendance data were collected retrospectively for the period 1988-97 inclusive for individuals who were aged 18 years or over. SETTING: Data were obtained on patients who were registered at the Katharine Dormandy Haemophilia Centre (KDHC), London, UK. OUTCOME MEASURES: In-patient stays, Out-patient and day-case visits. RESULTS: Individuals with mild/moderate haemophilia were 45% (31-56), 36% (30-41) and 70% (68-73) less likely to have required in-patient, Out-patient and day-case visits than were individuals with severe haemophilia. HIV serostatus and age were also shown to be significant and independent predictors of the rate of Out-patient and day-case visits, but not the rate of in-patient stays. CONCLUSION: These results suggest that primary prophylaxis for individuals with severe haemophilia could significantly reduce the demand for in-patient stays, and Out-patient and day-case visits.