Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel
Journal article
Laffan, M., McLaughlin, P., Motwani, J., Alamelu, J., Austin, S. Classey, S., Dolan, G., Eales, M., Gooding, R., Grainger, J., Harrison, C., Jones, A., Kelly, A., Oyesiku, L., Rodgers, R., Stephensen, D., Talks, K., Sonecha, S. and Danquah, A. 2024. Expert United Kingdom consensus on the preservation of joint health in people with moderate and severe haemophilia A: A modified Delphi panel. Haemophilia. https://doi.org/10.1111/hae.14934
Authors | Laffan, M., McLaughlin, P., Motwani, J., Alamelu, J., Austin, S. Classey, S., Dolan, G., Eales, M., Gooding, R., Grainger, J., Harrison, C., Jones, A., Kelly, A., Oyesiku, L., Rodgers, R., Stephensen, D., Talks, K., Sonecha, S. and Danquah, A. |
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Abstract | Aim: For people with haemophilia A (PwHA), bleeding in the joints leads to joint damage and haemophilia-related arthropathy, impacting range of motion and life expectancy. Existing guidelines for managing haemophilia A support healthcare professionals (HCPs) and PwHA in their efforts to preserve joint health. However, such guidance should be reviewed, considering emerging evidence and consensus as presented in this manuscript. Methods: Fifteen HCPs experienced in the management of PwHA in the UK participated in a three-round Delphi panel. Consensus was defined at ≥70% of panellists agreeing or disagreeing for Likert-scale questions, and ≥70% selecting the same option for multiple- or single-choice questions. Questions not reaching consensus were revised for the next round. Results: 26.8% (11/41), 44.8% (13/29) and 93.3% (14/15) of statements reached consensus in Rounds 1, 2 and 3, respectively. HCPs agreed that prophylaxis should be offered to patients with a baseline factor VIII (FVIII) level of ≤5 IU/dL and that, where there is no treatment burden, the aim of prophylaxis should be to achieve a trough FVIII level ≥15 IU/dL and maintain a longer period with FVIII levels of ≥20-30 IU/dL to provide better bleed protection. The aspirational goal for PwHA is to prevent all joint bleeds, which may be achieved by maintaining normalised (50-150 IU/dL) FVIII levels. Conclusion: The panel of experts were largely aligned on approaches to preserving joint health in PwHA, and this consensus may help guide HCPs. |
Keywords | Delphi method; United Kingdom; Haemophilia A; Joint pain; Joints |
Year | 2024 |
Journal | Haemophilia |
Publisher | Wiley |
ISSN | 1351-8216 |
1365-2516 | |
Digital Object Identifier (DOI) | https://doi.org/10.1111/hae.14934 |
Official URL | https://onlinelibrary.wiley.com/doi/10.1111/hae.14934 |
Publication dates | |
Online | 19 Jan 2024 |
Publication process dates | |
Accepted | 30 Dec 2023 |
Deposited | 22 Jan 2024 |
Publisher's version | License File Access Level Open |
Output status | Published |
https://repository.canterbury.ac.uk/item/96x30/expert-united-kingdom-consensus-on-the-preservation-of-joint-health-in-people-with-moderate-and-severe-haemophilia-a-a-modified-delphi-panel
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Publisher's version
Haemophilia - 2024 - Laffan - Expert United Kingdom consensus on the preservation of joint health in people with moderate.pdf | ||
License: CC BY-NC 4.0 | ||
File access level: Open |
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