VPB0681 - Adherence to prophylaxis and bleeding outcome in haemophilia: A multicentre Nigerian study

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

Theresa U. Nwagha, MPH,FMCPatg

Consultant Haematologist
University of Nigeria , College of Medicine Ituku Ozalla Campus
Enugu, Enugu, Nigeria

Co-Author(s)

HO

Helen Chioma Okoye, FMCPath, FWACP

Consultant
Department of Haematology and Immunology, College of Medicine, University of Nigeria Ituku Ozalla Campus Enugu, Nigeria
Enugu, Enugu, Nigeria
SY

Saleh Yuguda, MBBS, FMCPath

Reader/Consultant Haematologist
Federal Teaching Hospital Gombe/Gombe State University
Gombe, Gombe, Nigeria
CU

Christiana Udo

Consultant Haematologist
National Hospital, Abuja, Nigeria.
Abuja, Federal Capital Territory, Nigeria
MO

Mutiat Ogunfemi

Consultant Haematologist
Department of Haematology and Blood Transfusion, University of Ilorin, Kwara State, Nigeria
Ilorin, Kwara, Nigeria
DG

Dalhat Gwarzo

Senior Lecturer/Consultant Haematologist
Department of Haematology and Blood Transfusion, Aminu Kano Teaching Hospital, Kano, Nigeria
Kano, Kano, Nigeria
ON

Osuji Nnamdi Joel

Haematologist
National Hospital, Abuja, Nigeria.
Abuja, Federal Capital Territory, Nigeria

Background: Low-dose prophylaxis is the standard of care as it reduces bleeding, development of target joints, arthropathy, and improvement of quality of life. Non-adherence or poor adherence can prevent the achievement of these outcomes. The levels and determinants of (non-)adherence among people with haemophilia (PWH) in Sub Saharan Africa have not been evidenced.

Aims: To evaluate self-reported adherence among PWH, provide evidence of determinants/predictors of adherence, and establish the associations between non-adherence and presence of target joints and annualized bleed rate (ABR).

Methods: A cross-sectional survey of 42 participants on low-dose prophylaxis recruited from five haemophilia treatment centers in Nigeria using validated Haemophilia Regimen Treatment Adherence Scale - Prophylaxis (VERITAS-Pro). Information on the presence of target joints, the number of target joints, and ABR were collected from medical files.

Results: The mean age of the participants was 9.79 (6.29) years, with 96.6% having hemophilia A and 79.3% having target joints. Overall adherence to the prophylaxis regimen was 81.0%. The mean total VERITAS-Pro for the adherent group and the non-adherent group was 37.35±9.08 and 63.0±6.37, respectively. The mean subscale scores for the adherent group ranged from 0.67 (communication) to 8.68 (planning), while for the non-adherent group the mean subscale scores range from 1.0 communication to 13.88 (planning). The mean difference of all except the dosing subscale was statistically significant with p< 0.05. Only the skipping subscale showed a statistically significant positive correlation with ABR in the non-adherent group p=0.02.

Conclusion(s): The findings indicate that adherence was very good, and most were in communication with their treatment centers. The skipping sub-scale was significantly associated with ABR for the non-adherent group. Interventions aimed at improving adherence are the key to better treatment outcomes. A multicenter study is needed to assess the reason for poor adherence.
We acknowledge Natalie Duncan for Indiana Haemophilia and Thrombosis Center for sharing VERITAS-PRO.