Knowledge, attitude and practice of health care providers toward prescribing factor replacement at federally funded haemophilia treatment centres in the United States
M. Bloomberg
University of Miami Haemophilia Treatment CenterMiami, US
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, K. Sargenton
University of Miami Haemophilia Treatment CenterMiami, US
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, K. Gattamorta
University of Miami School of Nursing & Health StudiesMiami, US
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y D. Anglade
University of Miami School of Nursing & Health StudiesMiami, US
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17 oct 2020
Acerca de este artículo
Categoría del artículo: Clinical Practice
Publicado en línea: 17 oct 2020
Páginas: 121 - 128
DOI: https://doi.org/10.17225/jhp00165
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© 2020 M. Bloomberg et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Participant demographic information
| Female | 70 | 59.3% |
| Male | 26 | 22.0% |
| Missing data | 22 | 18.7% |
| Hematologist | 43 | 36.6% |
| Staff nurse | 4 | 3.4% |
| Advanced practice registered nurse (NP) | 19 | 16.1% |
| Physician assistant | 1 | 0.8% |
| Nurse coordinator | 30 | 25.4% |
| Missing data | 21 | 17.8% |
| ADN | 2 | 3.8% |
| BSN | 22 | 41.5% |
| MSN | 21 | 39.6% |
| Doctorate (PhD, DNP, EdD) | 4 | 7.5% |
| Other | 4 | 7.5% |
| Paediatric | 43 | 36.4% |
| Adults | 19 | 16.1% |
| Both | 34 | 28.8% |
| Missing data | 22 | 18.6% |
| New England | 11 | 9.3% |
| Mid-Atlantic | 11 | 9.3% |
| Southeast | 18 | 15.3% |
| Great Lakes | 20 | 16.9% |
| Northern States | 2 | 1.7% |
| Great Plains | 17 | 14.4% |
| Mountain States | 8 | 6.8% |
| Western States | 10 | 8.5% |
| Academic centre | 70 | 59.3% |
| Private clinic or hospital | 15 | 12.7% |
| Community/public clinic or hospital | 11 | 9.3% |
| Independent, self-standing HTC | 10 | 8.5% |
| Missing data | 12 | 10.2% |
Perceptions of patient motivation leading to a request to change prescribed factor concentrate
| Less frequent dosing option | 0 (0) | 2 (2.4) | 0 (0) | 32 (38.1) | 50 (59.5) |
| Lower out-of-pocked cost | 5 (5.9) | 8 (9.4) | 11 (12.9) | 21 (24.7) | 40 (47.1) |
| Insurance preferred drug list | 13 (15.5) | 14 (16.7) | 18 (21.4) | 19 (22.6) | 20 (23.8) |
| Concerns about inhibitor development | 2 (2.4) | 15 (17.6) | 12 (14.1) | 30 (35.3) | 26 (30.6) |
| Strong commitment of manufacturer to haemophilia community | 11 (12.9) | 17 (20.0) | 24 (28.2) | 26 (30.6) | 7 (8.2) |
| Patient/caregiver brand loyalty | 4 (4.7) | 7 (8.2) | 11 (12.9) | 41 (48.2) | 22 (25.9) |
| Therapy recommended by friend/family | 4 (4.8) | 10 (11.9) | 13 (15.5) | 45 (53.6) | 12 (14.3) |
| Therapy recommended by pharmaceutical representative | 9 (10.6) | 19 (22.4) | 21 (24.7) | 28 (32.9) | 8 (9.4) |
| Poor response to current therapy (breakthrough bleeds) | 0 (0) | 3 (3.5) | 9 (10.6) | 27 (31.8) | 46 (54.1) |
| Factor characteristics (volume to be infused, mixing device, vial sizes) | 1 (1.2) | 3 (3.5) | 7 (8.2) | 46 (54.1) | 28 (32.9) |
| Patient/family's relationship with a pharmaceutical representative | 11 (12.9) | 12 (14.1) | 14 (16.5) | 29 (34.1) | 19 (22.4) |
| Recommendation by specialty pharmacy | 17 (20.0) | 13 (15.3) | 16 (18.8) | 30 (35.5) | 9 (10.6) |
| Attendance to an industry sponsored dinner | 17 (20.0) | 9 (10.6) | 24 (28.2) | 23 (27.1) | 12 (14.1) |
| Other | 1 (25.0) | 0 (0.0) | 1 (25.0) | 1 (25.0) | 1 (25.0) |
Driving forces for changing a patient's factor concentrate
| Less frequent dosing option | 0 (0) | 6 (7.1) | 4 (4.8) | 41 (48.8) | 33 (39.3) |
| Lower out-of-pocked cost | 5 (5.9) | 8 (9.4) | 14 (16.5) | 34 (40.0) | 24 (28.2) |
| Insurance preferred drug list | 10 (11.9) | 11 (13.1) | 19 (22.6) | 30 (35.7) | 14 (16.7) |
| Concerns about inhibitor development | 3 (3.5) | 6 (10.6) | 11 (23.5) | 27 (55.3) | 38 (44.7) |
| Strong commitment of manufacturer to haemophilia community | 34 (40.5) | 14 (57.1) | 26 (88.1) | 6 (7.1) | 4 (4.8) |
| Patient/caregiver brand loyalty | 15 (17.9) | 15 (17.9) | 29 (34.5) | 18 (21.4) | 7 (8.3) |
| Patient/caregiver requested a switch in product | 0 (0) | 5 (6.0) | 8 (9.6) | 38 (45.8) | 32 (38.6) |
| Therapy recommended by friend/family/acquaintance | 30 (35.7) | 18 (21.4) | 25 (29.8) | 11 (13.1) | 0 (0) |
| Poor response to current therapy (breakthrough bleeds) | 0 (0) | 0 (0) | 1 (1.2) | 12 (14.1) | 72 (84.7) |
| Inadequate PK studies | 0 (0) | 4 (4.8) | 12 (14.3) | 27 (32.1) | 41 (48.8) |
| Non-adherent to current therapy | 1 (1.2) | 0 (0) | 4 (47.1) | 40 (47.1) | 40 (47.1) |
| Other | 1 (12.5) | 0 (0) | 0 (0) | 2 (25.0) | 5 (62.5) |