Clinical attributes and treatment characteristics are associated with work productivity and activity impairment in people with severe haemophilia A

Introduction Few studies have examined the real-world impact of haemophilia on daily activities and work productivity in people with severe haemophilia A (PWSHA). Aim To determine clinical attributes and treatment characteristics associated with impairment in daily activities and work among PWSHA using the patient-reported Work Productivity and Activity Impairment-General Health Questionnaire (WPAI-GH). Methods PWSHA were asked to complete the WPAI-GH as part of the Cost of Haemophilia in Europe: A Socioeconomic Survey (CHESS) study. Outcomes were determined for activity impairment (AI), absenteeism, presenteeism and overall work productivity loss (WPL). Descriptive statistics and regression analyses were used to evaluate the association between these outcomes and clinical and treatment attributes. Results Overall, 376 participants completed the AI element of WPAI-GH; 175 were employed and thus also reported on work impact. Mean +/- standard deviation scores were as follows: AI = 34.2% +/- 25.8%; absenteeism = 0.06% +/- 0.2%; presenteeism = 26.8% +/- 22.4%; WPL = 28.6% +/- 24.0%. Increased AI and WPL were associated with high haemophilia-related morbidity, measured both as chronic pain (p < .001 for both) and joint synovitis (AI: p p = .017). In descriptive and multivariate analyses, lifelong prophylaxis was associated with reduced AI (p p = .031, respectively); high therapy adherence was associated with reduced AI (p = .001 and p = .012, respectively) and with reduced WPL (p p = .012, respectively). Conclusion The WPAI-GH identified haemophilia-related morbidity and treatment characteristics, including therapy regimen and adherence, as key attributes impacting functional impairment and work contributions of PWSHA. Early prophylactic intervention and greater adherence to therapy may lead to lower AI and WPL in PWSHA.

Automated summary

The study identified the impact of haemophilia-related morbidity and treatment characteristics on daily activities and work productivity in people with severe haemophilia A. Higher morbidity levels such as chronic pain and joint synovitis were associated with increased impairment in daily activities and work productivity loss. Lifelong prophylaxis and high therapy adherence were shown to be associated with reduced impairment in daily activities and work productivity loss in PWSHA.