Health status and health-related quality of life of children with haemophilia from six West European countries.
A multicentre, international, cross-sectional study was carried out in the frame of field testing of the first haemophilia-specific quality-of-life (QoL) questionnaire (Haemo-QoL). The aim of this paper is to describe health status and health care and their impact on QoL in haemophilic children in Western Europe. Children aged 4-16 years with severe haemophilia without inhibitors were enrolled by 20 centres in France, Germany, Italy, the Netherlands, Spain and the United Kingdom. Clinical information was collected by the physicians with a medical documentation form. Health-related QoL (HRQoL) of children was assessed with Haemo-QoL, available for three age groups. Clinical data were available in 318 patients, 85.5% with haemophilia A. The mean age at first bleeding was 11 months, at first joint bleed 25 months. Functional joint impairments were found in 11.3%. Prophylaxis treatment was given to 66.7% of children in whom breakthrough bleeds occurred 0.4 times a month compared to 1.1 bleeds in children receiving on-demand treatment. A significantly higher factor consumption was found only in the two younger age groups of prophylaxis patients compared to on-demand patients. HRQoL was satisfactory in this cohort: young children were impaired mainly in the dimension 'family' and 'treatment', whereas older children had higher impairments in the so-called 'social' dimensions, such as 'perceived support' and 'friends'. Health care of children in Western Europe is progressively improving with a large diffusion of home treatment and prophylaxis. This provides a high level of health status and HRQoL, being better in haemophilic adolescents on prophylaxis.
Angelo Bianchi Bonomi Haemophilia and Thrombosis Centre, Department of Internal Medicine, IRCCS Maggiore Hospital and University of Milan, Milan, Italy. alessandro.gringeri@unimi.it
A
A
Gringeri
S
S
von Mackensen
G
G
Auerswald
M
M
Bullinger
R
R
Perez Garrido
E
E
Kellermann
K
K
Khair
H
H
Lenk
M
M
Vicariot
A
A
Villar
C
C
Wermes
D000293:Adolescent; D017668:Age of Onset; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe; D006304:Health Status; D006467:Hemophilia A / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D007223:Infant; D011788:Quality of Life