Factors Associated with Adherence to Factor Replacement in the Hemophilia Population Open Access
Tran Jr., Duc Quang (2015)
Background: Hemophilia is a bleeding disorder managed with factor replacement products though adherence is complex. Health literacy (HL) is the degree to which one can understand health information and make health decisions. Numeracy deals with probability and numerical concepts. The primary aim was to see if there was an association between poor HL and numeracy in patients with hemophilia (PWH) and decreased adherence to factor replacement therapy. Other aims include the investigation of associations between other factors such as physician trust, quality of life, and depression history and adherence to factor replacement therapy.
Methods: In a cross-sectional study, adult PWH were recruited during the Hemophilia Treatment Center (HTC) visit. They completed questionnaires to obtain adherence, HL, and numeracy measurements, as well as other independent variables. Multiple regression was performed to determine the association between poor HL and numeracy with adherence to factor replacement therapy while adjusting for possible confounders.
Results: All were men (n=99); 91% had hemophilia A and 78% had severe disease. Age ranged from 18 to 62, with a mean age 33 (SD 18). Most were white (69%). Mean duration followed at HTC was 16.0 years (SD 11). Depression history was reported in 21%. Most (95%) had high HL; but only 23% were numerate. The mean adherence scores were 45.6 (SD 18) and 51.0 (SD 15) depending on regimen prescribed. On multivariable analysis, HL score and numerate status were not significantly associated with adherence. Being on any chronic medication, longer duration seen at HTC, higher physician trust, and better quality of life were associated with higher adherence. Depression history was associated with lower adherence.
Conclusion: In this study population, numeracy was not associated with adherence. A large majority of the PWH in our study were health literate. This study showed being on any chronic medication, longer duration followed at the HTC, higher physician trust, better quality of life, and no depression history were associated with better adherence. These factors provide a better understanding of characteristics that influence adherence and may prove important for optimizing the care of PWH.
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About this Master's Thesis
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