A multidisciplinary approach to optimising the virtual management of haemophilia: a roundtable meeting of UK experts

Author:

Benson Gary1ORCID,Bhandari Trupti2,Gomez Keith3ORCID,Holder Kerry-Ann4,Stephensen David5ORCID,Wilkinson Alice6,Mangles Sarah7ORCID

Affiliation:

1. Northern Ireland Haemophilia Comprehensive Care Centre, Belfast City Hospital , Belfast , Northern Ireland

2. Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust , London , UK

3. Royal Free London NHS Foundation Trust , London , UK

4. Noah’s Ark Children’s Hospital for Wales , Cardiff , UK

5. Kent Haemophilia and Thrombosis Centre, East Kent Hospitals University NHS Foundation Trust , Kent , UK

6. Oxford Paediatric Haemophilia and Thrombosis Centre , Oxford , UK

7. Haemophilia, Haemostasis and Thrombosis Centre, Basingstoke and North Hampshire Hospital , Basingstoke , UK

Abstract

Abstract The necessity of a multidisciplinary team (MDT) approach in haemophilia care is well recognised globally, with international guidelines advocating this. Prior to the coronavirus disease 2019 pandemic, virtual MDT haemophilia care was gaining support worldwide. However, the pandemic necessitated the rapid implementation of innovative virtual solutions to ensure continued access to multidisciplinary care. A multidisciplinary panel of healthcare professionals who specialise in haemophilia care in the United Kingdom gathered to discuss the following: the current landscape of haemophilia MDT care and best practices, the benefits, challenges, and opportunities for virtual MDT care, managing bleeds remotely, virtual paediatric care, and the future of virtual MDT care. The consensus was that virtual MDT care is widely used, however formats vary depending on the healthcare setting, available resources, MDT preferences, and local policy. Advisors agreed that virtual MDT care has several benefits, such as improved convenience/choice for their patients and wider patient reach. However, many patient-specific and logistical challenges exist. Hybrid care models may provide an opportunity to overcome these challenges. The decision on how bleeds are managed (virtually versus face-to-face) depends on provider preference, the patient-provider relationship, and the patient’s disease severity, history, and ability to self-manage. As such, this should be assessed on a case-by-case basis. Virtual tracking tools cannot be solely relied upon for MDT decisionmaking as patient accuracy cannot be ascertained. The MDT composition for paediatric care should be tailored to the patients’ and their parents’/caregivers’ needs. Lastly, hybridised care will likely be adopted for future haemophilia management and will facilitate the advancement of MDT care.

Publisher

Walter de Gruyter GmbH

Reference46 articles.

1. Centers for Disease Control and Prevention. What is Hemophilia? 2022. Available from https://www.cdc.gov/ncbddd/hemophilia/facts.html (accessed January 2023).

2. Beny K, du Sartz de Vigneulles B, Carrouel F, et al. Haemophilia in France: Modelisation of the clinical pathway for patients. Int J Environ Res Public Health 2022; 19(2): 646. doi: 10.3390/ijerph19020646.

3. Srivastava A, Santagostino E, Dougall A, et al. WFH Guidelines for the Management of Hemophilia, 3rd edition. Haemophilia 2020; 26 Suppl 6: 1-158. doi: 10.1111/hae.14046.

4. Mehta P, Reddivari AKR. Hemophilia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 30 Sep 2022.

5. Roche. Summary of Product Characteristics – Hemlibra. Available from https://www.ema.europa.eu/en/documents/product-information/hemlibra-epar-product-information_en.pdf (accessed March 2023).

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