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Clinical, economic, and health-related quality of life burden associated with von Willebrand disease in adults and children : Systematic and targeted literature reviews

Castaman, Giancarlo ; Katsarou, Olga ; Jansen, Nathalie ; Santos, Sandra ; Escolar, Ginés and Berntorp, Erik LU (2023) In Haemophilia 29(2). p.411-422
Abstract

Introduction: Debilitating clinical complications in von Willebrand disease (VWD) can affect health-related quality of life (HRQoL), increase healthcare costs and cause long-lasting consequences. However, the magnitude of these burdens needs to be more fully explored. Aim: To estimate the prevalence and burden of clinical complications, the impact on HRQoL and the economic burden associated with VWD. Methods: Embase®, MEDLINE®, the Cochrane Library and conference proceedings were searched for studies on VWD evaluating clinical complications, HRQoL and cost and resource use. Results: Among 16 studies assessing clinical complications in VWD, the most prevalent bleeding symptoms were menorrhagia (2%–95% [n = 7... (More)

Introduction: Debilitating clinical complications in von Willebrand disease (VWD) can affect health-related quality of life (HRQoL), increase healthcare costs and cause long-lasting consequences. However, the magnitude of these burdens needs to be more fully explored. Aim: To estimate the prevalence and burden of clinical complications, the impact on HRQoL and the economic burden associated with VWD. Methods: Embase®, MEDLINE®, the Cochrane Library and conference proceedings were searched for studies on VWD evaluating clinical complications, HRQoL and cost and resource use. Results: Among 16 studies assessing clinical complications in VWD, the most prevalent bleeding symptoms were menorrhagia (2%–95% [n = 7 studies]), epistaxis (12%–80% [n = 6]) and easy bruising (46%–65% [n = 2]). Among 17 studies evaluating HRQoL, the most common assessment scales were the generic SF-36 (n = 8 studies) and the EQ-5D (n = 2). Bleeding symptoms were associated with reduced QoL in six of seven studies, and of six studies evaluating treatment impact, four reported improvements in one or more HRQoL components. Among 25 studies on cost and resource use, key observations included higher post-surgery healthcare costs in VWD versus non-VWD patients (n = 1 study) and higher costs and resource use in VWD patients with bleeding complications versus those without (n = 1). Conclusion: Although limited, available evidence suggests that VWD patients experience a high burden of clinical complications, reduced QoL and high healthcare costs. Haemarthrosis is more common in severe VWD than is often assumed, and bleeds (including haemarthrosis) can reduce QoL. Research efforts to improve QoL and other outcomes should be prioritized.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bleeding, complications, haemarthrosis, health-related quality of life, healthcare costs, von Willebrand disease
in
Haemophilia
volume
29
issue
2
pages
411 - 422
publisher
Wiley-Blackwell
external identifiers
  • pmid:36097135
  • scopus:85137897923
ISSN
1351-8216
DOI
10.1111/hae.14655
language
English
LU publication?
yes
id
46ef6bd8-0a5e-47c5-b01d-be18ffa5843c
date added to LUP
2022-12-05 09:07:31
date last changed
2024-06-13 22:41:42
@article{46ef6bd8-0a5e-47c5-b01d-be18ffa5843c,
  abstract     = {{<p>Introduction: Debilitating clinical complications in von Willebrand disease (VWD) can affect health-related quality of life (HRQoL), increase healthcare costs and cause long-lasting consequences. However, the magnitude of these burdens needs to be more fully explored. Aim: To estimate the prevalence and burden of clinical complications, the impact on HRQoL and the economic burden associated with VWD. Methods: Embase<sup>®</sup>, MEDLINE<sup>®</sup>, the Cochrane Library and conference proceedings were searched for studies on VWD evaluating clinical complications, HRQoL and cost and resource use. Results: Among 16 studies assessing clinical complications in VWD, the most prevalent bleeding symptoms were menorrhagia (2%–95% [n = 7 studies]), epistaxis (12%–80% [n = 6]) and easy bruising (46%–65% [n = 2]). Among 17 studies evaluating HRQoL, the most common assessment scales were the generic SF-36 (n = 8 studies) and the EQ-5D (n = 2). Bleeding symptoms were associated with reduced QoL in six of seven studies, and of six studies evaluating treatment impact, four reported improvements in one or more HRQoL components. Among 25 studies on cost and resource use, key observations included higher post-surgery healthcare costs in VWD versus non-VWD patients (n = 1 study) and higher costs and resource use in VWD patients with bleeding complications versus those without (n = 1). Conclusion: Although limited, available evidence suggests that VWD patients experience a high burden of clinical complications, reduced QoL and high healthcare costs. Haemarthrosis is more common in severe VWD than is often assumed, and bleeds (including haemarthrosis) can reduce QoL. Research efforts to improve QoL and other outcomes should be prioritized.</p>}},
  author       = {{Castaman, Giancarlo and Katsarou, Olga and Jansen, Nathalie and Santos, Sandra and Escolar, Ginés and Berntorp, Erik}},
  issn         = {{1351-8216}},
  keywords     = {{bleeding; complications; haemarthrosis; health-related quality of life; healthcare costs; von Willebrand disease}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{411--422}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Haemophilia}},
  title        = {{Clinical, economic, and health-related quality of life burden associated with von Willebrand disease in adults and children : Systematic and targeted literature reviews}},
  url          = {{http://dx.doi.org/10.1111/hae.14655}},
  doi          = {{10.1111/hae.14655}},
  volume       = {{29}},
  year         = {{2023}},
}