Primary prophylaxis for individuals with severe haemophilia: how many hospital visits could treatment prevent?

Objectives. To assess how many hospital visits primary prophylaxis with clo tting factor could prevent. Design. The potential for reducing hospital visits was assessed by comparin g rates of in-patient, Out-patient and day-case visits per patient-year for individuals with severe (< 1 IU dL(-1)) haemophilia who had never received primary prophylaxis with attendance rates for individuals with mild/modera te (1-50 IU dL(-1)) haemophilia. Hospital attendance data were collected re trospectively for the period 1988-97 inclusive for individuals who were age d 18 years or over. Setting. Data were obtained on patients who were registered at the Katharin e Dormandy Haemophilia Centre (KDHC), London, UK. Outcomes measures. In-patient stays, Out-patient and day-case visits. Results. Individuals with mild/moderate haemophilia were 45% (31-56), 36% ( 30-41) and 70% (68-73) less likely to have required in-patient, Out-patient and day-case visits than were individuals with severe haemophilia. HIV ser ostatus and age were also shown to be significant and independent predictor s of the rate of Out-patient and day-case visits, but not the rate of in-pa tient stays. Conclusion. These results suggest that primary prophylaxis for individuals with severe haemophilia could significantly reduce the demand for in-patien t stays, and Out-patient and day-case visits.