Bleeding disorders, menorrhagia and iron deficiency: impacts on health-related quality of life

Authors

  • C. Rae,

    1. Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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  • W. Furlong,

    1. Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
    2. Health Utilities Inc., Dundas, ON, Canada
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  • J. Horsman,

    1. Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
    2. Health Utilities Inc., Dundas, ON, Canada
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  • E. Pullenayegum,

    1. Father Sean O'Sullivan Research Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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  • C. Demers,

    1. Department of Hematology, Hôpital Enfant-Jesus, Quebec City, QC, Canada
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  • J. St-Louis,

    1. Department of Hematology/Oncology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada
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  • D. Lillicrap,

    1. Department of Pathology, Queen's University, Kingston, ON, Canada
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  • R. Barr

    Corresponding author
    1. Departments of Pediatrics, Pathology and Medicine, McMaster University, Hamilton, ON, Canada
    • Centre for Health Economics and Policy Analysis, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
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Correspondence: Ronald Barr, Room 3N27B, Health Sciences Centre, McMaster University, 1200 Main Street West, Hamilton ON, L8S 4J9, Canada.

Tel.: +1 905 521 2100 X 73464; fax: +1 905 521 1703;

e-mail: rbarr@mcmaster.ca

Summary

von Willebrand disease (VWD) is a bleeding disorder that occurs in up to 1% of the general population. The great majority of females with VWD experience menorrhagia. The morbidity burden in females with VWD may relate to iron deficiency resulting from menorrhagia. To explore relationships between bleeding disorders, menorrhagia, iron deficiency and the outcomes of health-related quality of life (HRQL) and educational attainment. All subjects with VWD, and females with other bleeding disorders, in the Canadian national registry who were more than 12 years of age were eligible for survey. Survey measures included the HEALTH UTILITIES INDEX®; abridged Clinical History Assessment Tool; socio-demographic questions and serum ferritin. Statistical analyses included testing differences among groups of means using analysis of variance and of proportions using chi-squared test. Significant size differences in mean HRQL scores were detected between VWD females and both females with other bleeding disorders [diff = (−0.08); P = 0.017] and VWD males [diff = (−0.07); P = 0.039]. Mean HRQL scores differed between females with and without menorrhagia (P < 0.001). Mean HRQL scores were not significantly different between females with and without iron deficiency. Educational attainment was not associated with disease group, menorrhagia status or iron status. Females with VWD have a greater morbidity burden than females in the general population, females with other bleeding disorders and males with VWD. Menorrhagia is associated with low HRQL scores in females with bleeding disorders, including VWD. Further investigation should assess how menorrhagia impacts HRQL in females with bleeding disorders.

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