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Supervised Patient-Management of Hemophilia: A Study of 45 Patients with Hemophilia A and B

PETER H. LEVINE, M.D.; and ANTHONY F. H. BRITTEN, M.D.
[+] Article and Author Information

Supported in part by grants from Scientific Products Division, Abbott Laboratories, North Chicago, Ill., and Hyland Laboratories, Costa Mesa, Calif.

▸ Requests for reprints should be addressed to Peter H. Levine, M.D., 171 Harrison Ave., Boston, Mass. 02111.


Ann Intern Med. 1973;78(2):195-201. doi:10.7326/0003-4819-78-2-195
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Forty-five patients with hemophilia A and B were formally instructed in the management of their bleeding problems. Home infusion was permitted without prior consultation with a physician. Data from 12 months of this program were compared with results from the previous year. There was 74% reduction in absenteeism, 89% reduction in days hospitalized, 76% reduction in outpatient visits, and 45% decrease in health care costs. Use of factor VIII or IX decreased slightly. No patients had morbidity attributable to this program. The only important hazard was the exposure of family members to hepatitis from contaminated needles; one case occurred. These results, coupled with a gratifying trend towards more normal life patterns, suggest that the more widespread application of this form of therapy is justified. Hemophilia self-therapy may provide a useful model for improving the delivery of health care in certain other chronic illnesses.

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