Impact of Functional Disability on Quality of Life in Patients with Haemophilia: An Observational Study
KC05-KC08
Correspondence
Ashish Kavia,
30, Green View Colony, Patiala-147001, Punjab, India.
E-mail: ashishkavia60@gmail.com
Introduction: Haemophilia is a disease characterised by multiple episodes of spontaneous as well as traumatic bleeding leading to joint pains, joint damage. As a result, there may be disability ultimately leading to a compromised Health Related Quality of Life (HRQoL). This impairment is related to the severity of the clotting factor defect, bleeding frequency and orthopaedic problems.
Aim: To find out the correlation of quality of life with functional disability in patients with haemophilia A and B.
Materials and Methods: This observational study was conducted from April 2012 to November 2013 on 88 patients with haemophilia A and B, aged between 11 to 50 years. The Physical Component Summary (PCS) and Mental Component Summary (MCS) score was calculated using the short form health survey (SF-36) questionnaire, which is used to assess HRQoL. Gilbert score was used for assessing functional disability. The patients were analysed at initial presentation and then at six months follow-up. All scores were calculated at both times, and comparison was done according to different age groups as well severity of haemophilia. Correlation between SF-36 and Gilbert score was evaluated using various statistical methods.
Results: All 88 patients were males with the mean age was 21±9.9 years, with 90.91% being type A haemophilia and 9.09% being type B haemophilia. Clinical presentation of haemophilia patients included bleeding into joints and muscles, gum bleed and epistaxis. Mean scores for PCS and MCS at the initial evaluation were 26.34 and 28.53 and after six months the scores were 29.79 and 29.87, respectively. The overall mean Gilbert score for different age group at initial evaluation and six months were 4.46 and 3.20, respectively. Gilbert score increased with age as well increasing severity of haemophilia. In comparison, PCS and MCS scores decreased with age as well as with increasing severity. Using linear regression and correlation, a negative correlation between functional disability and HRQoL was found.
Conclusion: Negative correlation between functional disability and quality of life suggested that when there is increase in functional disability there is a decrease in quality of life. Also, as severity of haemophilia increases the functional disability and quality of life decreases. Therefore, an early intervention in haemophilia patients is important to reduce functional disability. The quality of life can be improved by limiting the functional disability. These findings should aid in improving healthcare delivery to the patients of haemophilia.