Prophylactic Factor Infusions for Patients with Hemophilia: Challenges with Treatment Adherence
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Review Article
Prophylactic Factor Infusions for Patients with Hemophilia: Challenges with Treatment Adherence
D Courtney Thornburg
Affiliations: Duke University Medical Center
ABSTRACT
Prophylaxis to prevent chronic arthropathy is recommended for all patients with severe hemophilia. However, effective implementation can be hampered by poor adherence with prescribed infusions. Reported adherence with prophylaxis has been excellent in the Joint Outcomes Study and in several clinical settings, but suboptimal in other reports. In clinical practice, physicians and nurses should identify patients at risk for non‐adherence and work closely with families to overcome barriers. Adherence research has previously been limited by the lack of a validated adherence instrument. Now that a validated instrument is available, measures to improve adherence can be tested. Methods to improve adherence should increase the likelihood of physician prescription of prophylaxis, and make prophylaxis easier to implement and more effective for individual patients.
Keywords: Hemophilia, hemarthrosis, prophylactic treatment, treatment adherence, clinical outcome
Correspondence: Courtney D Thornburg, Duke University Medical Center, Box 102382, Durham, NC 27710, USA. Tel: (1)‐919‐684‐3401; Fax: (1)‐919‐681‐7950; e‐mail: thorn006@mc.duke.edu
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