Home treatment of haemophilia patients with inhibitors


J. Omolara O. Oyesiku, Oxford Haemophilia Centre and Thrombosis Centre, Churchill Hospital, Old Road, Oxford OX3 7LJ, UK.
Tel.: +44 (0) 1865 225 343; fax: +44 (0) 1865 225 608;
e-mail: lara.oyesiku@orh.nhs.uk


Summary.  Bleeding episodes in patients with inhibitors can be challenging to treat. Clinical guidelines recognize the importance of early treatment, ideally within 2 h of the onset of bleeding. On-demand haemophilia care at home has been shown to reduce the time between recognition of the symptoms of bleeding and initiation of treatment. Rapid resolution of bleeding is associated with longer-term benefits for the patient. Effective haemophilia care at home depends on patients and carers taking greater responsibility for treatment; however, many find this difficult. Education can help raise awareness of haemophilia treatment at home and provide helpful information for patients/carers. The haemophilia nurse has a key role in providing this support and education. This review discusses a number of recent guidelines and educational materials for haemophilia home care identified during a literature survey. The survey shows that most materials were not validated. In addition, the survey shows limited effectiveness data on techniques for training haemophilia patients about home care. Further education resources and research in the treatment of haemophilia at home are required.