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The journey of gene therapy in haemophilia - Putting the patient at the centre of the hub and spoke model

Noone, Declan ; Astermark, Jan LU ; O'Mahony, Brian ; Peyvandi, Flora ; Khair, Kate ; Pembroke, Luke and Jenner, Kathryn (2022) In Journal of Haemophilia Practice 9(1). p.156-166
Abstract

As gene therapy for haemophilia is now licensed in Europe, and the hub and spoke approach is widely promoted for its delivery and follow-up, it is essential that people with haemophilia (PwH) who are eligible and opt to have this treatment are enabled to obtain the maximum benefit. Ensuring the pathway that makes up the patient gene therapy journey is effective is key to achieving this. EAHAD and the EHC have recommended that gene therapy is delivered through a hub and spoke model of care to ensure that the right expertise is available throughout the various stages of the haemophilia gene therapy journey. Effective communication between hub and spoke centres is essential, and the processes that make up the journey must be understood... (More)

As gene therapy for haemophilia is now licensed in Europe, and the hub and spoke approach is widely promoted for its delivery and follow-up, it is essential that people with haemophilia (PwH) who are eligible and opt to have this treatment are enabled to obtain the maximum benefit. Ensuring the pathway that makes up the patient gene therapy journey is effective is key to achieving this. EAHAD and the EHC have recommended that gene therapy is delivered through a hub and spoke model of care to ensure that the right expertise is available throughout the various stages of the haemophilia gene therapy journey. Effective communication between hub and spoke centres is essential, and the processes that make up the journey must be understood clearly by both PwH and the multidisciplinary teams delivering their care. The starting point for this is to take each step of the gene therapy journey in turn - through initial engagement, eligibility, detailed patient education, informed decision-making, dosing, and follow up in year 1, year 2 and beyond - and to consider and identify the roles and responsibilities of the patient, the hub centre and the spoke centre. It is important that the expectations of both health care practitioners (HCPs) and patients are aligned with the key challenges and goals associated with each step. Understanding these from the patient point of view will help to ensure that the individual PwH treading this path receive the information, guidance and support they need from hub and spoke HCPs throughout their journey, and that they, as the patient, remain the focus of care. Visualising the journey may help to explain the gene therapy clinical pathway to PwH and could provide a useful tool for HCPs in spoke centres. Visualisation may also serve as a tool for facilitating discussion, not only in terms of initial engagement and education, but throughout the haemophilia gene therapy journey.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Decision making, Follow-up, Gene therapy, Haemophilia, Hub and spoke care model, Patient-centred care
in
Journal of Haemophilia Practice
volume
9
issue
1
pages
11 pages
publisher
Sciendo
external identifiers
  • scopus:86000383369
DOI
10.2478/jhp-2022-0021
language
English
LU publication?
yes
id
1dd397ee-e38f-4c8f-8641-d50fafa603a2
date added to LUP
2025-06-05 11:16:48
date last changed
2025-06-05 11:18:00
@article{1dd397ee-e38f-4c8f-8641-d50fafa603a2,
  abstract     = {{<p>As gene therapy for haemophilia is now licensed in Europe, and the hub and spoke approach is widely promoted for its delivery and follow-up, it is essential that people with haemophilia (PwH) who are eligible and opt to have this treatment are enabled to obtain the maximum benefit. Ensuring the pathway that makes up the patient gene therapy journey is effective is key to achieving this. EAHAD and the EHC have recommended that gene therapy is delivered through a hub and spoke model of care to ensure that the right expertise is available throughout the various stages of the haemophilia gene therapy journey. Effective communication between hub and spoke centres is essential, and the processes that make up the journey must be understood clearly by both PwH and the multidisciplinary teams delivering their care. The starting point for this is to take each step of the gene therapy journey in turn - through initial engagement, eligibility, detailed patient education, informed decision-making, dosing, and follow up in year 1, year 2 and beyond - and to consider and identify the roles and responsibilities of the patient, the hub centre and the spoke centre. It is important that the expectations of both health care practitioners (HCPs) and patients are aligned with the key challenges and goals associated with each step. Understanding these from the patient point of view will help to ensure that the individual PwH treading this path receive the information, guidance and support they need from hub and spoke HCPs throughout their journey, and that they, as the patient, remain the focus of care. Visualising the journey may help to explain the gene therapy clinical pathway to PwH and could provide a useful tool for HCPs in spoke centres. Visualisation may also serve as a tool for facilitating discussion, not only in terms of initial engagement and education, but throughout the haemophilia gene therapy journey.</p>}},
  author       = {{Noone, Declan and Astermark, Jan and O'Mahony, Brian and Peyvandi, Flora and Khair, Kate and Pembroke, Luke and Jenner, Kathryn}},
  keywords     = {{Decision making; Follow-up; Gene therapy; Haemophilia; Hub and spoke care model; Patient-centred care}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{156--166}},
  publisher    = {{Sciendo}},
  series       = {{Journal of Haemophilia Practice}},
  title        = {{The journey of gene therapy in haemophilia - Putting the patient at the centre of the hub and spoke model}},
  url          = {{http://dx.doi.org/10.2478/jhp-2022-0021}},
  doi          = {{10.2478/jhp-2022-0021}},
  volume       = {{9}},
  year         = {{2022}},
}