<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Introduction</h3>
<p>For people with haemophilia (PwH) who live in developing countries, haemophilia continues to be a condition with serious medical and social consequences. In Morocco, the efforts of patient associations and medical teams have led to the creation of a national programme for haemophilia care since the end of 2012, and the country is no longer solely reliant on World Federation of Hemophilia (WFH) donations for access to factor products. There is growing recognition of the impact of the pain experienced by PwH. To continue to improve treatment for PwH in Morocco, it is important to ensure that they are also able to manage haemophilia-related pain.</p>
</sec>
<sec>
<h3>Aims</h3>
<p>This study aims to describe the prevalence, characteristics, and effects of pain experienced by PwH in Morocco for the first time, in order to increase understanding, and to support consideration of interventions and improvements in care.</p>
</sec>
<sec>
<h3>Methods</h3>
<p>We conducted a prospective, descriptive survey of the experience of pain in PwH attending the Department of Clinical Hematology and Pediatric Oncology in Casablanca, using the Multidimensional Hemophilia Pain Questionnaire (MHQP) approved by the WFH. All PwH with mild, moderate or severe haemophilia and over 18 years of age who presented to the department during the study period were included; consent was obtained. The data collection period lasted 6 months from October 2020 to April 2021.</p>
</sec>
<sec>
<h3>Results</h3>
<p>60 PwH completed the questionnaire (51 haemophilia A, 9 haemophilia B; 38 severe, 22 moderate). All respondents had experienced pain, 90% during the previous year and 75% during the last 3 months. 60% reported the occurrence of pain more than once a week. 65% reported that the right knee was the most painful site in the past year, followed by the right ankle (58%). The right knee was also the site of pain with the most negative impact in the past year. 58% responded that the evening was the time of most intense pain. The therapeutic strategies used against pain were pharmacological and non-pharmacological. 60% of respondents reported using analgesics and 50% reported using coagulation factor substitution for pain relief. Regarding non-pharmacological strategies, rest was reported by 40%, elevation of the painful site/change of position by 20%, and ice by 10%. The majority reported being satisfied or very satisfied with the current treatment of their pain by health professionals.</p>
</sec>
<sec>
<h3>Conclusion</h3>
<p>This study shows that pain is still very present in PwH treated at our haemophilia centre, with a significant impact on different areas of life. There is a need for action to standardise treatment approaches and develop protocols for pain management in PwH.</p>
</sec>
</abstract>

Introduction
For people with haemophilia (PwH) who live in developing countries, haemophilia continues to be a condition with serious medical and social consequences. In Morocco, the efforts of patient associations and medical teams have led to the creation of a national programme for haemophilia care since the end of 2012, and the country is no longer solely reliant on World Federation of Hemophilia (WFH) donations for access to factor products. There is growing recognition of the impact of the pain experienced by PwH. To continue to improve treatment for PwH in Morocco, it is important to ensure that they are also able to manage haemophilia-related pain.


Aims
This study aims to describe the prevalence, characteristics, and effects of pain experienced by PwH in Morocco for the first time, in order to increase understanding, and to support consideration of interventions and improvements in care.


Methods
We conducted a prospective, descriptive survey of the experience of pain in PwH attending the Department of Clinical Hematology and Pediatric Oncology in Casablanca, using the Multidimensional Hemophilia Pain Questionnaire (MHQP) approved by the WFH. All PwH with mild, moderate or severe haemophilia and over 18 years of age who presented to the department during the study period were included; consent was obtained. The data collection period lasted 6 months from October 2020 to April 2021.


Results
60 PwH completed the questionnaire (51 haemophilia A, 9 haemophilia B; 38 severe, 22 moderate). All respondents had experienced pain, 90% during the previous year and 75% during the last 3 months. 60% reported the occurrence of pain more than once a week. 65% reported that the right knee was the most painful site in the past year, followed by the right ankle (58%). The right knee was also the site of pain with the most negative impact in the past year. 58% responded that the evening was the time of most intense pain. The therapeutic strategies used against pain were pharmacological and non-pharmacological. 60% of respondents reported using analgesics and 50% reported using coagulation factor substitution for pain relief. Regarding non-pharmacological strategies, rest was reported by 40%, elevation of the painful site/change of position by 20%, and ice by 10%. The majority reported being satisfied or very satisfied with the current treatment of their pain by health professionals.


Conclusion
This study shows that pain is still very present in PwH treated at our haemophilia centre, with a significant impact on different areas of life. There is a need for action to standardise treatment approaches and develop protocols for pain management in PwH.

Pain assessment and management in the Moroccan haemophilia population: a prospective descriptive study

The Journal of Haemophilia Practice

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Introduction
For people with haemophilia (PwH) who live in developing countries, haemophilia continues to be a condition with serious medical and social...

	NO PAIN	MILD PAIN	MODERATE PAIN	SEVERE PAIN	WORST PAIN POSSIBLE
During bleeding episodes	4%	7%	27%	37%	25%
During physical efforts	6%	14%	15%	46%	19%
While walking up and down stairs	17%	15%	29%	31%	8%
After resting or staying still	29%	19%	21%	25%	6%
During rest	35%	26%	17%	15%	7%
After false movements	6%	21%	17%	31%	25%

	NUMBER (N)
Gender
Male	60 (100%)
Female	0
Age range
18-30	42 (70%)
31-45	15 (25%)
45-59	2 (3.3%)
>60	1 (1.6%)
Haemophilia type
Haemophilia A	51 (85%)
Haemophilia B	9 (15%)
Haemophilia severity*
Severe	38 (63%)
Moderate	22 (37%)
Mild	0
Inhibitor status
Inhibitors	6 (10%)
No inhibitors	54 (90%)
Treatment regimen
Low dose prophylaxis	8 (13%)
On-demand treatment	52 (87%)

TREATMENT STRATEGY	% OF RESPONDENTS (N)
Pain medication (analgesics, creams)	60% (36)
Rest	40% (24)
Elevation/change of position	20% (12)
Ice	10% (6)
Coagulation factor replacement	50% (30)
Prayer	6 (10%)

Pain assessment and management in the Moroccan haemophilia population: a prospective descriptive study

Article Category: Clinical Research

Publié en ligne: 17 juil. 2023

Pages: 48 - 55

DOI: https://doi.org/10.2478/jhp-2023-0010

Mots clés
Haemophilia, Pain management, Health-related quality of life

© 2023 Sofia Sraidi et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1.

Figure 2.

Reported pain intensity in different situations (N=60)

Participant demographics (N=60)

Therapeutic strategies used, with reported response rate (N=60)

Pain assessment and management in the Moroccan haemophilia population: a prospective descriptive study

Article Category: Clinical Research

Publié en ligne: 17 juil. 2023

Pages: 48 - 55

DOI: https://doi.org/10.2478/jhp-2023-0010

Mots clésHaemophilia, Pain management, Health-related quality of life

© 2023 Sofia Sraidi et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1.

Figure 2.

Reported pain intensity in different situations (N=60)

Participant demographics (N=60)

Therapeutic strategies used, with reported response rate (N=60)

Mots clés
Haemophilia, Pain management, Health-related quality of life