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Volume 1 (2013): Issue 1

How specialist nurse-led care can help to lower the costs of prophylaxis

Abstract

Abstract

Prophylaxis with factor VIII concentrates is beneficial for adults with severe haemophilia A, but prophylaxis regimens are costly. Guidelines recommend personalised prophylaxis tailored to bleeding phenotype and the result of pharmacokinetic assessments. This article describes a project in which specialist nurses played a pivotal role in identifying a small cohort of patients eligible for dose reduction. Nurses monitored patients following dose reduction, maintaining contact in order to address fears and ensure patient safety. The project led to a substantial cost saving for the Trust and demonstrates the value that nurses can bring to the haemophilia centre.

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References

  • 1. Richards M, Williams M, Chalmers E et al. A United Kingdom Haemophilia Centre Doctors’ Organization guideline approved by the British Committee for Standards in Haematology: guideline on the use of prophylactic factor VIII concentrate in children and adults with severe haemophilia A. Br J Haematology 2010; 149: 498-507.
  • 2. Morfini M. Pharmacokinetics of factor VIII and factor IX. Haemophilia 2003; 9 (Suppl 1): 94-9.
  • 3. Bjorkman S. Prophylactic dosing of factor VIII and factor IX from a clinical pharmacokinetic perspective. Haemophilia 2003; 9 (Suppl. 1): 101-8.
  • 4. Collins PW. Personalized prophylaxis. Haemophilia 2012; 18 (suppl. 4): 131-5.
  • 5. Anwar M, Uprichard J, Austin SK. Discrepant one-stage clotting versus chromogenic FVIII assays in haemophilia patients on ReFacto AF. Oral presentation at British Society for Haematology, Annual Scientific Meeting, 2013.

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