Loading…

Pain assessment and management in haemophilia: A survey among Italian patients and specialist physicians

Introduction Persons with haemophilia (PWH) experience recurrent joint bleeding which leads from early synovitis to irreversible joint damage. Pain strongly affects patients’ quality of life, as PWH suffer from acute pain associated with haemarthroses and chronic pain due to arthritic and degenerati...

Full description

Saved in:
Bibliographic Details
Published in:Haemophilia : the official journal of the World Federation of Hemophilia 2018-09, Vol.24 (5), p.766-773
Main Authors: Tagliaferri, Annarita, Franchini, Massimo, Rivolta, Gianna F., Farace, Stefania, Quintavalle, Gabriele, Coppola, Antonio, Arbasi, Maria Cristina, Aru, Anna Brigida, Baldacci, Erminia, Bonetti, Elisa, Cantori, Isabella, Cerbone, Anna Maria, Cocco, Antonio, Coluccia, Antonella, Contino, Laura, Cultrera, Dorina, Daniele, Filomena, De Cristofaro, Raimondo, Di Minno, Giovanni, Di Minno, Matteo N.D., Di Perna, Caterina, Ettorre, Cosimo Pietro, Feola, Giulio, Gamba, Gabriella, Giordano, Paola, Giuffrida, Gaetano, Luciani, Matteo, Mancuso, Maria Elisa, Marino, Renato, Molinari, Angelo Claudio, Pasta, Gianluigi, Pedrazzi, Paola, Pizzini, Attilia Maria, Pollio, Berardino, Radossi, Paolo, Raso, Simona, Rodorigo, Giuseppina, Santoro, Rita, Schiavoni, Mario, Schinco, Piercarla, Sottilotta, Gianluca, Speciale, Vincenzo, Todisco, Angelamaria, Turello, Marina, Zanon, Ezio
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Persons with haemophilia (PWH) experience recurrent joint bleeding which leads from early synovitis to irreversible joint damage. Pain strongly affects patients’ quality of life, as PWH suffer from acute pain associated with haemarthroses and chronic pain due to arthritic and degenerative complications. Aim To investigate pain issues among PWH and their treaters in Italy. Methods Persons with haemophilia and specialist physicians responded to a survey focused on pain characteristics, assessment, and management by phone call and online, respectively. Results One hundred and nineteen patients (76% severe haemophilia, 61% ≥18 years) and 44 physicians were involved. Pain was reported by 61% of PWH; among those who did not experience pain, 70% were children on prophylaxis. Patients described pain as chronic (71%), acute (69%) or postoperative (8%), and rated it as severe in 65% of cases. Clinicians reported lower percentages of patients with pain (46%), classified as chronic (58%), acute (33%) or postoperative (21%), half using specific scales. Pain was systematically investigated by treaters according to 36% of patients. Paracetamol was largely the most prescribed first‐line pain therapy (89%), as well the most employed analgesic by PWH (51%), who also used non‐steroidal anti‐inflammatory drugs (24%), cyclo‐oxygenase‐2 inhibitors (21%) or opioids (26%). To manage pain, 61% of clinicians stated to collaborate with other specialists. Physiotherapy was often suggested but less frequently used by PWH. Conclusions Pain is under‐recognized and unsatisfactorily addressed by haemophilia treatment centre (HTC) clinicians, with discrepant management compared to PWH responses. Education in systematic pain assessment and multidisciplinary treatment and development of management guidelines are highly needed.
ISSN:1351-8216
1365-2516
DOI:10.1111/hae.13600