Evaluation of primary care physicians’ approaches to hemophilia and bleeding disorders: a questionnaire survey

Abstract

Bleeding disorders are causes of great concern and panic for parents and primary care providers. Lack of knowledge and awareness on appropriate screening tests and factor product preparation contributed to potential diagnostic delays, increased complications, and economic costs. This study aimed to determine and compare the approach of primary care physicians (including general practitioners) and emergency physicians with a questionnaire including simulation-based cases on hemophilia. This simulation and two-stage questionnaire study was conducted with 244 participants. Before–after questionnaires, two case simulations, a brief presentation, and statistical analysis were performed. Participants mostly preferred tests, such as prothrombin time (PT) or partial thromboplastin time (PTT) to bleeding time for primary hemostasis (PT/PTT n: 192, 84.2%, bleeding time n: 94, 41.2%). Similar results were found for secondary hemostasis (bleeding time n: 144, 63.4%). There was a lack of knowledge in the management of simulation-based cases of acute hemorrhagic complications and factor product preparation (complication case: correct n: 100, 55.2%; initial doses correct n: 56, 43.4%, factor preparing correct n: 37, 49.3%, factor admission correct n: 36, 24.3%). All changed significantly, after the presentation (P = 0.000). Our study shows that there is probably a lack of knowledge of diagnostic investigations and appropriate factor product preparation with possible consequences for patients and economics.

Intracranial hemorrhage in children with hemophilia

“…Even if there is no index case in the family, it is necessary and recommended to suspect inherited bleeding disorders, especially hemophilias, in frontline differential diagnosis, while evaluating delivery-related hematomas of the neonatal period, as seen in many case reports and studies in the literature (18,19). Besides the high suspicion index, the proper evaluation of screening tests by primary health care providers is important in order to avoid diagnostic delays (20).…”