VPB0682 - Adherence To On Demand Treatment Regimen And Bleeding Outcome (A Multicenter Nigerian Study)

Background: Given the disparate access to coagulation factor concentrates (CFC) in resource-constrained countries and individual preferences, on-demand therapy remains a treatment option for the management of haemophilia. Non-adherence can delay desired treatment outcomes There is a dearth of evidence on adherence to on-demand therapy among PWH in sub–Saharan Africa

Aims: To evaluate self-reported/ parent-reported adherence to on-demand therapy among PWH and establish the associations between adherence and presence of target joints and annualized bleed rate

Methods: A cross-sectional survey of 55 participants on episodic treatment recruited during outpatient appointments in 5 haemophilia treatment centers (HTC) across Nigeria using the validated Haemophilia Regimen Treatment Adherence Scale- Prophylaxis (VERITAS -PRN), 24 questions on six (four-item) subscales (treat, time, dose, plan, remember, and communicate). The options of VERITAS -PRN were represented in 5 Likert scale and possible subscale ranged from 4 points (most adherent)to 20 points (least adherent) and possible total score ranging from 24 (most adherent) to 120 (least adherent ) the cut off for overall adherence put at >61 to indicate non-adherence.

Results: Of the 55 participants, 94.1% both had haemophilia A and target joints. The majority, 51(92.7%) had scores indicating non adherence. The mean age of non-adherent and adherent participants were 19(13.9) years and 24(13.23) years, respectively. For the non-adherent, the overall mean score was 68.05(8.54) Subscale scores range from 9.38 (treat) to 15.00 (remember) There was a significant difference in the overall adherence scores and subscale scores between adherent and non-adherent participants with p value < 0.05 . There was a significant association between mean log of the number of target joints and the communicating subscale for the non-adherent group, r-0.61 p value < 0.05.

Conclusion(s): Adherence to on-demand therapy is generally poor. Most were non intentionally skipping their doses. The association between the communication subscale and the number of target joints was significant.