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Knowledge, attitude and practice of health care providers toward prescribing factor replacement at federally funded haemophilia treatment centres in the United States


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As the choice of treatment options increases, a survey on prescribing practices in the US looks at the driving forces that lead health care professionals to change a patient's factor concentrate, and their perceptions of what motivates patients to request a change to their prescription.
As the choice of treatment options increases, a survey on prescribing practices in the US looks at the driving forces that lead health care professionals to change a patient's factor concentrate, and their perceptions of what motivates patients to request a change to their prescription.

Participant demographic information

NO. (N=118)%
Gender
Female7059.3%
Male2622.0%
Missing data2218.7%
Current Position
Hematologist4336.6%
Staff nurse43.4%
Advanced practice registered nurse (NP)1916.1%
Physician assistant10.8%
Nurse coordinator3025.4%
Missing data2117.8%
Nursing Education*
ADN23.8%
BSN2241.5%
MSN2139.6%
Doctorate (PhD, DNP, EdD)47.5%
Other47.5%
Patient Population
Paediatric4336.4%
Adults1916.1%
Both3428.8%
Missing data2218.6%
Federal Region of HTC
New England119.3%
Mid-Atlantic119.3%
Southeast1815.3%
Great Lakes2016.9%
Northern States21.7%
Great Plains1714.4%
Mountain States86.8%
Western States108.5%
HTC associated with
Academic centre7059.3%
Private clinic or hospital1512.7%
Community/public clinic or hospital119.3%
Independent, self-standing HTC108.5%
Missing data1210.2%

Perceptions of patient motivation leading to a request to change prescribed factor concentrate

REASONNOT IMPORTANT N (%)SOMEWHAT IMPORTANT N (%)NEUTRAL N (%)IMPORTANT N (%)VERY IMPORTANT N (%)
Less frequent dosing option0 (0)2 (2.4)0 (0)32 (38.1)50 (59.5)
Lower out-of-pocked cost5 (5.9)8 (9.4)11 (12.9)21 (24.7)40 (47.1)
Insurance preferred drug list13 (15.5)14 (16.7)18 (21.4)19 (22.6)20 (23.8)
Concerns about inhibitor development2 (2.4)15 (17.6)12 (14.1)30 (35.3)26 (30.6)
Strong commitment of manufacturer to haemophilia community11 (12.9)17 (20.0)24 (28.2)26 (30.6)7 (8.2)
Patient/caregiver brand loyalty4 (4.7)7 (8.2)11 (12.9)41 (48.2)22 (25.9)
Therapy recommended by friend/family4 (4.8)10 (11.9)13 (15.5)45 (53.6)12 (14.3)
Therapy recommended by pharmaceutical representative9 (10.6)19 (22.4)21 (24.7)28 (32.9)8 (9.4)
Poor response to current therapy (breakthrough bleeds)0 (0)3 (3.5)9 (10.6)27 (31.8)46 (54.1)
Factor characteristics (volume to be infused, mixing device, vial sizes)1 (1.2)3 (3.5)7 (8.2)46 (54.1)28 (32.9)
Patient/family's relationship with a pharmaceutical representative11 (12.9)12 (14.1)14 (16.5)29 (34.1)19 (22.4)
Recommendation by specialty pharmacy17 (20.0)13 (15.3)16 (18.8)30 (35.5)9 (10.6)
Attendance to an industry sponsored dinner17 (20.0)9 (10.6)24 (28.2)23 (27.1)12 (14.1)
Other1 (25.0)0 (0.0)1 (25.0)1 (25.0)1 (25.0)

Driving forces for changing a patient's factor concentrate

REASONNOT IMPORTANT N (%)SOMEWHAT IMPORTANT N (%)NEUTRAL N (%)IMPORTANT N (%)VERY IMPORTANT N (%)
Less frequent dosing option0 (0)6 (7.1)4 (4.8)41 (48.8)33 (39.3)
Lower out-of-pocked cost5 (5.9)8 (9.4)14 (16.5)34 (40.0)24 (28.2)
Insurance preferred drug list10 (11.9)11 (13.1)19 (22.6)30 (35.7)14 (16.7)
Concerns about inhibitor development3 (3.5)6 (10.6)11 (23.5)27 (55.3)38 (44.7)
Strong commitment of manufacturer to haemophilia community34 (40.5)14 (57.1)26 (88.1)6 (7.1)4 (4.8)
Patient/caregiver brand loyalty15 (17.9)15 (17.9)29 (34.5)18 (21.4)7 (8.3)
Patient/caregiver requested a switch in product0 (0)5 (6.0)8 (9.6)38 (45.8)32 (38.6)
Therapy recommended by friend/family/acquaintance30 (35.7)18 (21.4)25 (29.8)11 (13.1)0 (0)
Poor response to current therapy (breakthrough bleeds)0 (0)0 (0)1 (1.2)12 (14.1)72 (84.7)
Inadequate PK studies0 (0)4 (4.8)12 (14.3)27 (32.1)41 (48.8)
Non-adherent to current therapy1 (1.2)0 (0)4 (47.1)40 (47.1)40 (47.1)
Other1 (12.5)0 (0)0 (0)2 (25.0)5 (62.5)
eISSN:
2055-3390
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
Volume Open
Fachgebiete der Zeitschrift:
Medizin, Vorklinische Medizin, Grundlagenmedizin, andere, Klinische Medizin, Pharmazie, Pharmakologie