title: Patient preference and ease of use for different coagulation factor VIII reconstitution device scenarios: a cross-sectional survey in five European countries.
abstract: BACKGROUND
  Hemophilia A treatment involves replacing the deficient coagulation factor VIII. This process may involve multiple steps that might create a barrier to adherence. A new dual-chamber syringe (DCS; FuseNGo(®)) was recently introduced with the aim of simplifying reconstitution.
  
  
  OBJECTIVE
  This study aimed to identify factors associated with adult patients' preferences for different coagulation factor VIII reconstitution systems and to test ease of use and patient preference for the DCS.
  
  
  METHODS
  A cross-sectional survey of adults with hemophilia A in five European countries was conducted; a subset of subjects also participated in a practical testing session of the DCS.
  
  
  RESULTS
  Among the 299 survey participants, the device scenario requiring the least equipment and reconstitution steps (the DCS) received a median preference rating of 71 out of 100 (0 being "the least desirable" and 100 "the most desirable" rating). This was significantly higher than the other scenarios (the next highest achieved a median of 50 points; P<0.001). Participants would be more likely to use this device prophylactically (P<0.001). Among the 98 participants who tested the DCS, 57% preferred this device over their current device, 26% preferred their current device, and 17% had no preference. The DCS was rated as easier to use than current treatment devices (median score 9/10 versus 7/10 for current treatment, P=0.001).
  
  
  CONCLUSIONS
  The survey indicates that the prefilled DCS, FuseNGo(®), requiring the least equipment and fewest reconstitution steps, was preferred by patients and was the device most likely to be used prophylactically; the practical device testing supports these results.
authors.affiliation: Dipartimento Medicina Clinica e Sperimentale, Universita' degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Cimino
authors.affiliation: Agenzia per l' Emofilia, AOU Careggi di Firenze, Florence, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Linari
authors.affiliation: Fondazione Cà Granda Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi "A Bianchi Bonomi", Milan, Italy.
authors.forename: Mara
authors.initials: M
authors.lastname: Malerba
authors.affiliation: CRC Coagulation Research Centre GmbH, Duisburg, Germany.
authors.forename: Susan
authors.initials: S
authors.lastname: Halimeh
authors.affiliation: Pfizer Italia, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Biondo
authors.affiliation: Pfizer Italia, Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Westfeld
keywords: dual-chamber syringe; factor VIII; hemophilia; patient preference; reconstitution