Lacking Employment, College Education Negatively Impacts Hemophilia Patients, Study Finds

Being unemployed or under-educated can have a negative effect on hemophilia patients’ quality of life, including their pain levels and ability to function, according to the results of a questionnaire that were presented at the ASH Annual Meeting and Exposition.

In the patients surveyed, increased pain, functional impairment and reduced quality of life were associated with aging, having a history of joint procedures, viral disease, co-morbidities, being unemployed and lacking college education.

The presentation of the study abstract, titled “Linear and Logistic Regression Models of Patient-Reported Outcomes and Patient Characteristics in US Adults with Hemophilia from the Pain, Functional Impairment, and Quality of Life (P-FiQ) Study,” was made in December.

Katherine Batt, MD, of Wake Forest Baptist Medical Center and study leader, and colleagues administered several patient-reported outcome (PRO) questionnaires to 381 adult mild-to-severe hemophilic patients with a history of joint pain or bleeding, in order to assess pain, functional impairment and quality of life.

Patients were asked to complete a pain history questionnaire and to respond to five PRO measurements: EQ-5D-5L with visual analog scale (VAS), Brief Pain Inventory v2 Short Form (BPI), International Physical Activity Questionnaire (IPAQ), SF-36v2 overall health, and Hemophilia Activities List (HAL).

The team used additional data from the Pain, Functional Impairment and Quality of Life (P-FIQ) study and, through statistical methods, determined associations between patient characteristics and responses to PRO instruments.

According to the findings, 68% of the participants had employment and 61% had university degrees. About 71% of patients had severe hemophilia and 50% reported a history of joint procedures.

Moreover, 85% of the patients reported experiencing pain and 67% felt restricted at school, work and during recreational activities during the previous six months.

The most common co-morbidities and viral diseases were found to include Hepatitis C virus (HCV) in 32% of patients, depression in 19%, cardiovascular disease in 19%, human immunodeficiency virus (HIV) infection in 16%, anxiety in 14% and diabetes in 6% of patients.

Having a history of joint procedures, viral diseases, co-morbidities and severe hemophilia was linked to functional impairment (as measured by HAL).

Moreover, having a history of joint procedures, viral disease and comorbidities was linked to a reduction in physical activity, as measured by IPAQ.

Having a history of joint procedures, viral disease, co-morbidities, lack of college education and unemployment was linked to pain severity, as determined by BPI.

Overall health state, as measured by EQ-5D-5L with VAS, was associated with having a history of joint procedures, viral disease, co-morbidities, and no current or past history of inhibitors, as well as a lack of college education, unemployment and older age.

Finally, having a history of routine factor infusions, younger age, no co-morbidities, severe hemophilia and employment was linked to overall health, as measured by SF-36v2.

“We identified sociodemographic characteristics and comorbidities potentially associated with PRO measurements,” Batt said at the oral presentation, according to a press release. “Measuring PRO during clinical encounters may facilitate monitoring the impact of patient characteristics on important health outcomes.”