Objective:

To evaluate the effect of the implementation of a smart-phone based therapy management application over the monitoring of the hemophilia A (HA) and B (HB) patients in home-care setting.

Setting:

Since 2016 our hospital is using a mobile app and real time therapy management system for hemophilia patients (Haemoassist™, StatConsult) as a new tool of hemophilia patients care management complementing the existing health charts.

Methods:

A retrospective research conducted at one hemophilia treatment center covering four islands. HA and HB patients using the mobile app with at least 6-month follow-up period were included. Data on socio-demographics, clinical and therapy were collected before and after 6-month period of the app introduction. Sources of information were the electronic medical history (Millenium-Cerner™), pharmacy outpatient delivery program (Hospiwin™) and the above mentioned smart-phone app.

The adherence was estimated calculating real factor consumption divided by the theoretical factor consumption according to prescribed prophylactic regimen for each study period. The extra doses for bleeding episodes were collected only after the intervention, due to unavailable reliable reports for mild and moderate bleeding events before the incorporation of the app.

Results:

A total of 28 patients with severe and moderate HA and HB on prophylactic treatment were included. The median age was 25 years (range 3-57). The median of the first period adherence was 72.7 % (range 30.77-100%) and of the second was 100% (range 51.88-100%). The median of the difference between periods was 15% (see chart 1 for more detailed information). In the post-intervention period, 12 (43 %) patients had a median of 3 bleeding events (range 1 -7) and needed extra-infusions with a median of 7 doses (range 3-17).

Conclusions:

The adherence to prophylactic treatment is crucial to reduce joint bleedings (Manco-Johnson MJ et al. NEJM. 2007). The use of therapy management mobile app has contributed to increase adherence in our patients allowing a precise monitoring of the administered factor and bleeding events in real time.

Figure.
Figure.
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Disclosures

No relevant conflicts of interest to declare.

Topics:
hemophilia a, mobile health, patient care management, telehealth, hemorrhage, prevention, follow-up, hemorrhagic episodes, medical history, mobile applications

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2018 by The American Society of Hematology
2018
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