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Pain Status in Patients with Hemophilia: Evaluation of Routine Pain Assessment in an Unselected Cohort of Patients with Hemophilia A and B

K. Holstein1, K. Veltrup1, M. Tetzlaff1, G. Schröder1, S. von Mackensen2, F. Langer1

1University Medical Center Hamburg-Eppendorf, II. Medical Department, Hemophilia Center, Hamburg, Germany, 2University Medical Center Hamburg-Eppendorf, Institute of Medical Psychology, Hamburg, Germany

Abstract Number: PB1009

Meeting: ISTH 2020 Congress

Theme: Hemophilia and Rare Bleeding Disorders » Hemophilia - Clinical

Background: Pain is a common co-morbidity in patients with hemophilia (PWH). Most data on prevalence of pain is generated by patient surveys with potential selection bias or within clinical studies.

Aims: To analyze prevalence of pain in an unselected cohort of PWH visiting a single German hemophilia center for routine annual check-ups during the previous 5 years.

Methods: Assessment of pain intensity (numeric rating scale, NRS, 0 [no pain] to 10 [worst imaginable pain]) and location over the previous 3 months was carried out with an ad-hoc questionnaire. Pain interference was rated on a scale from 0 to 10 with higher values indicating more interference. Impact on mood was reported as none, moderate or severe. Demographic and clinical data were extracted from patient charts.

Results: 184 male adult PWH A or B visited the center, of whom 155 (84%) completed at least 1 questionnaire (93%, 81%, 65% of PWH with severe, moderate, mild hemophilia, respectively) with a median age at first assessment of 39 years (range, 18-77 years). 141/155 PWH (91%) reported episodes of pain with a median intensity (NRS) of 6 (range, 1-10), 5 (1-10), 3 (1-9) and median number of affected joints of 2, 2, 1 (range, 0-6) in PWH with severe, moderate, mild hemophilia, respectively. Only 9% of patients reported no pain and 15 patients (9.7%) had pain only in locations other than joints. Median pain interference in PWH with pain was rated 4 (range, 0-10); 51, 64, 22 PWH reported no, moderate and severe impact on mood, respectively.

Conclusions: This analysis of a routinely used pain assessment tool in an unselected population of PWH A and B reveals a high prevalence of pain episodes as well as relevant pain interference and impact on mood. Further analyses of pain over time and intervention effects will be performed.

To cite this abstract in AMA style:

Holstein K, Veltrup K, Tetzlaff M, Schröder G, von Mackensen S, Langer F. Pain Status in Patients with Hemophilia: Evaluation of Routine Pain Assessment in an Unselected Cohort of Patients with Hemophilia A and B [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/pain-status-in-patients-with-hemophilia-evaluation-of-routine-pain-assessment-in-an-unselected-cohort-of-patients-with-hemophilia-a-and-b/. Accessed September 29, 2023.

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