Awareness and Perspectives of Non-Haematologist in the Management of Acquired Haemophilia in Arab Gulf Countries

Abstract

Objective: To assess the awareness around AH among healthcare professionals in the Gulf
region to whom patients with this serious disorder are likely to initially present and possibly
receive initial life saving treatment measures.
Methods: A survey was carried out in May 2013 among non-hematologist health care
professionals in 10 Arabian Gulf tertiary medical care centres to assess the degree of awareness
regarding AH diagnosis and management and to identify the difficulties they face during initial
management of such cases.
Results: The total number of responders to our survey was 1104, 953 of them were physicians,
57 laboratory staff physicians, and 94 pharmacists. Out of all physicians who responded, 42%
were not aware of AH, 45% would not consider mixing test for isolated prolonged aPTT and 47%
of them would start bypassing agents in bleeding AH, but only 26% would use inhibitor eradication
immediately upon confirmation. Almost half of the clinicians showed the hematologist's response
in more than 24 hrs. The majority of clinicians, lab and pharmacists agreed that the lack of
awareness about AH, and its complications, is the most important obstacle to achieving optimal
management. Despite the shortage of hematologists in the Arab Gulf countries, 46 of them did not
believe in empowering other health care professionals to start bypassing agents and inhibitor
eradications in such fatal disorders although they agreed with the need of increasing the
awareness among non hematologist health care workers
Conclusions:There is a general lack of awareness of Acquired Hemophilia in all non-hematology
specialized Healthcare providers in the Gulf region. Specific areas for improved awareness were
identified for different specialties. Some health care system areas for improvement could be
identified as well. There is still an unmet need to assess the current management practices of the
condition in the region to be able to formulate recommendations to optimize practices based on
local experience and available resources