Lower Adherence to Clotting Factor Replacement Therapy in Patients with Haemophilia Associated with More Depressive Symptoms: Two Centers Cross-Sectional Study

Butković, Ana; Bago, Martina; Zupan, Irena Preložnik; Kotnik, Barbara Faganel; Borojević, Ivana Prga; Vrca, Vesna Bačić; šalek, Silva Zupančić

doi:10.31577/sp.2022.01.839

Cited by 1 publication

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“…There is a strong rationale for MDTs to investigate even low-level depression and anxiety, with two recent studies observing that mild depressive symptoms were a primary driver of adherence to treatment among PwH. 32,33 More generally, effective monitoring could lead to earlier detection and intervention prior to any issues impacting significantly upon an individuals daily life and functioning. Even in MDTs lacking dedicated psychosocial support, many generic, validated screening tools (e.g., PHQ-9, GAD-7) are sensi-tive in capturing the impact of symptoms on daily activities and can be implemented by a non-specialist during routine appointments, allowing timely specialist referral, if needed.…”

Section: Discussionmentioning

confidence: 99%

“…Information on subclinical (subthreshold) anxiety or depression (i.e., anxious or depressive symptoms that do not meet standardised diagnostic thresholds for minor/major depression or anxiety) 29–31 was not available for our analysis cohort, which may correlate with the relative absence of physician‐reported A/D among individuals self‐reporting slight/moderate A/D symptoms. There is a strong rationale for MDTs to investigate even low‐level depression and anxiety, with two recent studies observing that mild depressive symptoms were a primary driver of adherence to treatment among PwH 32,33 . More generally, effective monitoring could lead to earlier detection and intervention prior to any issues impacting significantly upon an individuals daily life and functioning.…”

Section: Discussionmentioning

confidence: 99%

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Anxiety and depression among adults with haemophilia A: Patient and physician reported symptoms from the real‐world European CHESS II study

Ferri Grazzi,

Blenkiron,

Hawes

et al. 2024

Haemophilia

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IntroductionThe physical pain and disability affecting many people with haemophilia A (PwHA) are known detractors from psychological wellbeing. While psychosocial support is considered a core tenet of the haemophilia comprehensive care structure, the extent to which mental health challenges are detected and monitored by the individuals treating haematologist remains relatively unexplored.AimTo describe prevalence of anxiety and depression in a real‐world cohort of adult PwHA and evaluate the congruence in reporting of anxiety or depression (A/D) between PwHA and their treating physicians.MethodsData for PwHA without inhibitors was drawn from the European ‘Cost of Haemophilia: A Socioeconomic Survey II’ (CHESS II) study. Haematologist‐indicated comorbidities of anxiety and depression were unified into a single A/D indicator. The EQ‐5D‐5L health status measure was used to characterise self‐reported A/D, with individuals stratified into two non‐mutually exclusive subgroups based on level of A/D reported (Subgroup A: ‘some’ or above; Subgroup B: ‘moderate’ or above).ResultOf 381 PwHA with evaluable EQ‐5D‐5L responses, 54% (n = 206) self‐reported at least some A/D (Subgroup A) and 17% (n = 66) reported at least moderate A/D (Subgroup B). Patient‐physician congruence in A/D reporting was 53% and 76% for Subgroups A and B, respectively. Descriptive analysis suggested that individuals with physician‐ and/or self‐reported A/D experienced worse clinical outcomes (bleeding events, joint disease, chronic pain).ConclusionWhile adverse clinical outcomes appear to correlate with A/D, self‐reports of moderate–severe symptoms occasionally lacked formal recognition from treating physicians. Cross‐disciplinary surveillance of mental health issues could improve both psychological and clinical outcomes among PwHA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%