Effect of Implementation of COVID-19 Guidelines on the Lives of Haemophilia Patients Registered with the Haemophilia Treatment Centre, Rawalpindi

  • Tahira Zafar
  • Humera Siddique
  • Rana Zeeshan
  • Lubna Zafar
Keywords: Covid-19, Pandemic, Lockdown, Haemophilia Treatment Centre guidelines , Haemophilia, Haemophilia Treatment Centre.

Abstract

Introduction: The development of isolation strategies to prevent spread of COVID -19 could affect the lives of Haemophilia patients beyond the risk of infection. In order to prevent this, the Haemophilia Treatment Centre, Rawalpindi, adopted additional combat strategies including the use of telephonic and video consultations, dispensing medicine at home and single day treatments.
Objective: To assess the impact of COVID -19 pandemic and associated lockdown and changes in Standard Operating Procedures (SOPs) on the working of Haemophilia Treatment Centre, Rawalpindi and on the lives of its registered patients.
Methods: An observational study was carried out at the Haemophilia Treatment Centre, Rawalpindi, between September, 2019 and August, 2020. Written records of frequency of virtual/physical visits to the Centre, treatment compliance, bleeding episodes, musculoskeletal health, psychosocial health, pain, disability and inhibitor status were obtained from six months pre pandemic and followed prospectively six months into the pandemic.
Results: The Haemophilia Treatment remained open and functional throughout the study period. All staff members followed specially developed Haemophilia Treatment Centre guidelines vigilantly. Since telemedicine was encouraged , a rise in telephonic consultations was observed and therefore, no difference in overall visits was observed among the Pre- and Intra- Pandemic eras. The option of at-home dispensing of medicine via courier was available, and therefore, all patients remained treatment compliant. Among patients on Low Dose Prophylaxis (LDP) regimen, no difference in musculoskeletal health, bleeding episodes, inhibitor status, psychosocial health and nutritional status was observed among the two time periods. None of the staff members or patients were affected by the Covid-19.
Conclusion: Our study shows that timely anticipation of potential impact of a pandemic and prompt development of modified mechanisms can indeed make the working of a Health Care Centre successful and prevent side effects on the lives of its patients.

References

1. World Health Organization. Male Circumcision: Global Trends and Determinants of Prevalence, Safety and Acceptability. Geneva. UNAIDS. 2007.
2. Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, Ludlam CA, Mahlangu JN, Mulder K, Poon MC, Street A; Treatment Guidelines Working Group on Behalf of The World Federation Of Hemophilia. Guidelines for the management of Hemophilia. Haemophilia. 2013; 19(1): 1-47.
3. World Health Organisation. Infection Prevention and Control (IPC) for Novel Coronavirus (COVID-19) Course. https://openwho.org/courses/COVID-19-IPC-EN
4. World Federation of Hemophilia. COVID-19 (coronavirus disease 2019) pandemic caused by SARS-CoV-2: practical recommendations for hemophilia patients. 21 March 2020. Available at: https://news.wfh.org/covid-19-coronavirus-disease-2019-pandemic-caused-by-sars-cov-2-practical-recommendations-for-hemophilia-patients/.
5. World Federation of Hemophilia. Specific Risks of COVID-19 to the Bleeding Disorders Community. April 2, 2020. Available at https://news.wfh.org/specific-risks-of-covid-19-to-the-bleeding-disorders-community/
6. Zafar T, Zafar L, Ikram N. Guidelines for Haemophilia Treatment Centres during the COVID-19 Pandemic..https://.hpwsrwp.org.pk/
7. Valentino LA, Skinner MW, Pipe S. The role of telemedicine in the delivery of healthcare in the COVID-19 pandemic. Haemophilia. 2020 May 12;10.1111/hae.14044. doi: 10.1111/hae.14044. Online ahead of print.
8. Alvarez-Roman MT, De la Corte-Rodriguez H, Rodriguez-Merchan EC, et al. COVID-19 and telemedicine in hemophilia in a patient with severe hemophilia A and orthopedic surgery. Haemophilia. 2020 Jun 9. doi: 10.1111/hae.14087. Online ahead of print.
9. Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Intern Med. 2018; 178: 745-6.
10. Moazzami B, Razavi-Khorasani N, Dooghaie Moghadam A. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J Clin Virol. 2020; 126: 104345.
11. Alvarez-Roman MT, García-Barcenilla S, Cebanu T, et al. Clinical trials and Haemophilia during the COVID-19 pandemic: Madrid's experience. Haemophilia. 2020 May 16;10.1111/hae.14055. doi: 10.1111/hae.14055. Online ahead of print.
12. Pinto AJ, Dunstan DW, Owen N, et al. Combating physical inactivity during the COVID-19 pandemic.Nat Rev Rheumatol. 2020 Apr 30;1-2. doi: 10.1038/s41584-020-0427-z. Online ahead of print.
13. Rajkumar RP. COVID-19 and mental health: A review of the existing literature. Asian J Psychiatr. 2020; 52: 102066. doi: 10.1016/j.ajp.2020.102066. Online ahead of print.
14. Hortensia De la Corte-Rodriguez , M. Teresa Alvarez-Roman , Emerito Carlos Rodriguez-Merchan & Víctor Jimenez-Yuste (2020): What COVID-19 can mean for people with hemophilia beyond the infection risk, Expert Review of Hematology, DOI: 10.1080/17474086.2020.1818066.
15. Riley RR, Witkop M, Hellman E, et al. Assessment and management of pain in haemophilia patients. Haemophilia. 2011; 17: 839-45.
16. Kempton CL, Antoniucci DM, Rodriguez-Merchan EC. Bone health in persons with haemophilia. Haemophilia 2015;21:568–577.
17. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clin Exp Res. 2020 May 6; 1-4. doi: 10.1007/s40520-02001570-8. Online ahead of print.
Published
2021-08-31
How to Cite
1.
Zafar T, Siddique H, Zeeshan R, Zafar L. Effect of Implementation of COVID-19 Guidelines on the Lives of Haemophilia Patients Registered with the Haemophilia Treatment Centre, Rawalpindi. JRMC [Internet]. 31Aug.2021 [cited 25Sep.2021];25(1). Available from: https://journalrmc.com/index.php/JRMC/article/view/1601