An expert consensus to define how higher standards of equitable care for von Willebrand disease can be achieved in the UK and Republic of Ireland

Author:

Laffan Mike1ORCID,Benson Gary2ORCID,Farrelly Cathy3,Gomez Keith4,Jones April5,Maclean Rhona6,O'Donnell James78,Lavin Michelle78ORCID

Affiliation:

1. Centre for Haematology, Imperial College London London UK

2. NI Haemophilia Comprehensive Care Centre Belfast City Hospital Belfast UK

3. Liverpool Hospital Liverpool UK

4. Haemophilia Centre and Thrombosis Unit Royal Free London NHS Foundation Trust London UK

5. Royal Victoria Infirmary Newcastle UK

6. Sheffield Royal Hallamshire Sheffield UK

7. Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences Royal College of Surgeons in Ireland Dublin UK

8. National Coagulation Centre St James's Hospital Dublin UK

Abstract

AbstractIntroductionVon Willebrand Disease (VWD) is the most common inherited bleeding disorder. However, recognition of the disease by both the public and healthcare professionals lags behind that of other bleeding disorders, leading to delays in diagnosis and treatment for patients. Updated national guidelines are needed to highlight an appropriate pathway for managing VWD patients in a timelier manner.AimTo identify ways in which care for VWD can be achieved on a more equitable basis.MethodsUsing a modified Delphi approach, a panel of VWD experts developed 29 statements across five key themes. These were used to form an online survey that was distributed to healthcare professionals involved in VWD care across the UK and Republic of Ireland (ROI). Stopping criteria comprised 50 responses received, a 3‐month window for response (February—April 2022) and 90% of statements passing consensus threshold. Threshold for consensus for each statement was agreed at 75%.ResultsA total of 66 responses were analysed with 29/29 statements achieving consensus of which 27 attained ≥90% agreement. From the high degree of consensus, eight recommendations were derived regarding how detection and management of VWD can be improved to provide equity of care between men and women.ConclusionImplementation of these eight recommendations across the VWD pathway has the potential to raise the standard of care for patients in the UK and ROI by reducing delays to diagnosis and treatment initiation.

Publisher

Wiley

Subject

Genetics (clinical),Hematology,General Medicine

Reference30 articles.

1. ASH ISTH NHF WFH 2021 guidelines on the diagnosis of von Willebrand disease

2. Prophylactic management of patients with von Willebrand disease

3. New developments in von Willebrand disease

4. Irish Haemophilia Society. Von Willebrand Disorder.2020. Accessed October 1 2022.https://haemophilia.ie/app/uploads/2020/10/vWD‐New‐Edition‐2020.pdf

5. NICE. Heavy Menstrual Bleeding: Quality Standard 47. Updated2020. Accessed October 1 2022.https://www.nice.org.uk/guidance/qs47

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