title: The group medical appointment (GMA) in haemophilia and von Willebrand's disease: a new development in outpatient paediatric care.
abstract: The Group Medical Appointment (GMA) is a novel consultation form in which patients undergo individual consultations in each other's presence. To compare participants' experiences with GMA and Individual Medical Appointments (IMA), the usual standard of care, our team recently implemented the GMA for children aged 0-18 years with haemophilia or von Willebrand's disease. Participants' experiences with GMA were measured using a standardized QUOTE-questionnaire. Of 100 addressed families, 53 participated in GMA. Of these 53 families, 38 parents (72%) and 14 adolescents (82%) filled in the questionnaire about the GMA. Patients not on prophylaxis were defined as less experienced and patients on prophylaxis, as experienced. Although parents were satisfied with both GMA and IMA (median score 8.0 vs. 9.0 of 10), a significant difference was demonstrated between less experienced and experienced parents. After GMA, less experienced parents were significantly more satisfied (median score 8.0 vs. 5.0; P-value 0.006), felt more social support (82% vs. 30%; P-value 0.005) and reported additional learning effects with regard to disease and treatment (64% vs. 0%; P-value <0.001) than experienced parents. None of the less experienced parents reported privacy problems during GMA compared with 40% of experienced parents. In adolescents an identical trend was reported. Sixty-six per cent of parents would join a GMA in the future and 87% would recommend a GMA to others. The GMA is a valuable addition in haemophilia and von Willebrand care, especially for less experienced patients. It leads to improved satisfaction, social support and improved information.
authors.affiliation: Department of General Paediatrics Clinical Genetics Paediatric Oncology and Haematology, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Lock
authors.forename: A
authors.initials: A
authors.lastname: De Bruin
authors.forename: M
authors.initials: M
authors.lastname: Scholten
authors.forename: M
authors.initials: M
authors.lastname: Joosten
authors.forename: F M
authors.initials: FM
authors.lastname: Seesing
authors.forename: A
authors.initials: A
authors.lastname: Beishuizen
authors.forename: A
authors.initials: A
authors.lastname: De Goede-Bolder
authors.forename: M H
authors.initials: MH
authors.lastname: Cnossen
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000379:methods* / Q000639:trends; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D006123:Group Practice; D006467:Hemophilia A / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands; D010290:Parents; D010349:Patient Compliance; D017060:Patient Satisfaction; D012017:Referral and Consultation; D012944:Social Support; D011795:Surveys and Questionnaires; D014842:von Willebrand Diseases / Q000628:therapy*