Family issues in continuous infusion therapy with factor VIII.
Two recent advances in hemophilia therapy have led to clinical trials that incorporate more aggressive approaches to prevent bleeding complications. The production of factor VIII using recombinant DNA technology diminishes the risk of viral transmission in factor concentrate and thus increases safety. The administration of factor VIII by continuous infusion optimizes pharmacokinetics to achieve a sustained factor VIII level using the least number of units, and thus decreases cost. Providing factor concentrate by continuous infusion at home is very challenging to parents and children. Compliance can be supported by addressing issues that affect the family and its functioning. These issues include acceptance of the diagnosis, perception of the problem, parenting style, communication, social supports, disclosure issues, financial concerns, and perceived benefits and toxicities of the therapy plan. Health care providers must recognize and address these issues in order to provide adequate support for the family. Critical interventions include adequate time and optimal conditions for family education, support groups, determination of family expectations, understanding of parenting style, assistance with communication, disclosure, financial issues and clarification of the risks and benefits of various treatment plans.
Manco-Johnson
M J
MJ
United States Health Services of Colorado Hemophilia Center, Denver 80262, USA.
D005169:Factor VIII / Q000008:administration & dosage* / Q000627:therapeutic use; D005190:Family; D006467:Hemophilia A / Q000150:complications / Q000188:drug therapy*; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D007260:Infusion Pumps; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D005169:Factor VIII