Background: Home care management in Hemophilia is recommended by WFH as the standard care for patients with haemophilia (PwH) as it facilitates strict adherence to prophylaxis regime which in turn can reduces the emergency bleeding episodes ,hospitalization rates, economic burden of factor infusion and travelling difficulties during active bleeding.

Aims: The Aim of the study is to study the impact of implementation of home therapy and its benefits in PwH registered under Hemophilia Treatment Centre (HTC) of Assam Medical College and Hospital conducted for over a period of 5 years.

Methods: In this retrospective study conducted over a period of 5 years, PwH and the parents of Children with haemophilia (CwH) were trained for home infusions. Appropriate documentation and records of factor dosage, correct storage and handling of the products, careful preparation of factor concentrate were also taught.Data collected based on a questionnaire for doses of factor used by them for prophylaxis in HTC and at home or local medical centres. Bleeding rates, cost of transportation per prophylaxis treatment in HTC were also recorded. Transportation cost was calculated by taking into account the cost of transport per unit.

Results: During the study period of 5 years, a shift from 0% to 77% was seen for self/home infusion. Most children preferred treatment by family members rather than medical staff. Use of Factor concentrates on time reduced the risk of emergency hospitalization. Home therapy also reduced the expenditure cost, time and potential risk of health of the PwH belonging to distant area.

Conclusion(s): Use of home based factor concentrates reduced the time of treatment during emergency bleeds thus reducing the risk of emergency hospitalization and improving the quality of life in PwH, experiencing less pain and greater flexibility in daily activities and less absenteeism from school and work.

Image 1

Proportion of PwH undergoing prophylaxis treatment based on factor infusion

Table 1

Transportation fare in PwH before and after implementation of Home Infusion – p value calculated by chi-square test -.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/adherence-and-cost-effectively-of-home-based-prophylaxis-over-institutionalised-based-prophylaxis-in-patients-with-hemophilia-pwh-in-upper-assam/