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

Abstract

Miners AH, Sabin CA, Tolley KH, Lee CA (Royal Free Hospital School of Medicine, London; University of Nottingham, Nottingham; and Royal Free Hampstead NHS Trust, London, UK). Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent? J Intern Med 2000; 247: 493–499. 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.