title: Two decades of haemophilia treatment in the Netherlands, 1972-92.
abstract: Four questionnaire surveys were conducted over a period of 20 years to evaluate long-term effects of haemophilia treatment in the Netherlands. The response to the prestructured questionnaires in 1972, 1978, 1985 and 1992 varied between 70% and 84%. Data concerned treatment modalities, bleeding episodes, hospitalization, absenteeism, joint impairment and employment. Results over the period 1972-92 for patients with severe and moderately severe haemophilia showed that the use of prophylaxis had sharply increased (from 21% to 45%), as was the case for home treatment (from 4% to 62%). Consequently, the annual mean number of bleeds diminished from 19 to 13. Absence from school was markedly reduced (from 32 to 5 days), and sick leave in employed patients had also diminished (from 26 to 22 days). Furthermore, the use of inpatient hospital facilities, as well as employment in haemophilia patients, had nearly equalled that of the general Dutch male population. The self-reported degree of joint impairment showed no overall improvement, but in patients aged under 35 years there seemed to be a slight reduction in severe impairment. Patients aged under 15 years finally had no severe impairment at all. Social participation can only be further improved if arthropathy is prevented from an early age. Therefore adequate prophylactic regimens and close monitoring of joint impairment in young adults are needed.
authors.affiliation: Research Fellow, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.NVHP Coordinator, Netherlands Hernophilia Society (NVHP), Badhoevedorp, the Netherlands.Professor of Medical Psychology, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.Professor of Internal Medicine, Hemostasis and Thrombosis Research Centre, University Hospital Leiden, the Netherlands.Epidemiologist, Department of Clinical Epidemiology, and Hemostasis and Thrombosis Research Centre, University Hospital Leiden, Building 1, CO-P45, PO Box 9600, 2300 RC Leiden, the Netherlands.
authors.forename: A H
authors.initials: AH
authors.lastname: Triemstra
authors.affiliation: Research Fellow, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.NVHP Coordinator, Netherlands Hernophilia Society (NVHP), Badhoevedorp, the Netherlands.Professor of Medical Psychology, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.Professor of Internal Medicine, Hemostasis and Thrombosis Research Centre, University Hospital Leiden, the Netherlands.Epidemiologist, Department of Clinical Epidemiology, and Hemostasis and Thrombosis Research Centre, University Hospital Leiden, Building 1, CO-P45, PO Box 9600, 2300 RC Leiden, the Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Smit
authors.affiliation: Research Fellow, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.NVHP Coordinator, Netherlands Hernophilia Society (NVHP), Badhoevedorp, the Netherlands.Professor of Medical Psychology, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.Professor of Internal Medicine, Hemostasis and Thrombosis Research Centre, University Hospital Leiden, the Netherlands.Epidemiologist, Department of Clinical Epidemiology, and Hemostasis and Thrombosis Research Centre, University Hospital Leiden, Building 1, CO-P45, PO Box 9600, 2300 RC Leiden, the Netherlands.
authors.forename: H M
authors.initials: HM
authors.lastname: VAN DER Ploeg
authors.affiliation: Research Fellow, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.NVHP Coordinator, Netherlands Hernophilia Society (NVHP), Badhoevedorp, the Netherlands.Professor of Medical Psychology, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.Professor of Internal Medicine, Hemostasis and Thrombosis Research Centre, University Hospital Leiden, the Netherlands.Epidemiologist, Department of Clinical Epidemiology, and Hemostasis and Thrombosis Research Centre, University Hospital Leiden, Building 1, CO-P45, PO Box 9600, 2300 RC Leiden, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Briët
authors.affiliation: Research Fellow, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.NVHP Coordinator, Netherlands Hernophilia Society (NVHP), Badhoevedorp, the Netherlands.Professor of Medical Psychology, Department of Medical Psychology, Vrije Universiteit Amsterdam, the Netherlands.Professor of Internal Medicine, Hemostasis and Thrombosis Research Centre, University Hospital Leiden, the Netherlands.Epidemiologist, Department of Clinical Epidemiology, and Hemostasis and Thrombosis Research Centre, University Hospital Leiden, Building 1, CO-P45, PO Box 9600, 2300 RC Leiden, the Netherlands.
authors.forename: F R
authors.initials: FR
authors.lastname: Rosendaal
keywords: absenteeism; haemophilia; home treatment; hospitalization; joint impairment; prophylaxis