CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2023; 59(01): 021-026
DOI: 10.1055/s-0042-1760083
Original Article

Adherence and Cost Effectivity of Home-Based Prophylaxis Over Institutionalized Prophylaxis in Patients with Hemophilia

Anupam Dutta
1   Department of Medicine, Assam Medical College and Hospital, Dibrugarh, Assam, India
1   Department of Medicine, Assam Medical College and Hospital, Dibrugarh, Assam, India
Angshuman Boruah
1   Department of Medicine, Assam Medical College and Hospital, Dibrugarh, Assam, India
Arijit Das
1   Department of Medicine, Assam Medical College and Hospital, Dibrugarh, Assam, India
› Author Affiliations
Funding None.


Purpose: Home-based prophylaxis in hemophilia facilitates the treatment of patients with hemophilia (PwH) at home resulting in an improved quality of life, experiencing less pain and greater flexibility in daily activities. This literature studies the cost effectivity and adherence to prophylaxis treatment after the implementation of home-based prophylaxis therapy in PwH registered under the Hemophilia Treatment Centre (HTC) of Assam Medical College and Hospital.

Materials and Methods: PwH and their parents were advised for self/home infusion after being trained by a medical professional for 6 months. Data were collected on the skip in prophylaxis treatment by PwH and their traveling cost to access the prophylaxis treatment before and after the implementation of home infusion, through questionnaire and telephonic interview.

Results: The mean number of days of skip in prophylaxis was significantly reduced from 25 (±11) to 4 (±2) days after implementation of home infusion. The mean transportation cost was also found to be significantly decreased from Rs. 3297 (±2251) to 440 (±279). Before home/self-infusion, 77% of the registered PwH were found to skip prophylaxis doses more than 12 times a year but after home infusion, no PwH were found to skip more than 12 doses a year.

Conclusion: Home therapy facilitates the PwH to strictly adhere to the prophylaxis regime significantly reducing the skipping of doses to be administered to the PwH. The risks of regular traveling and the burden of transportation expenditure to avail the prophylaxis treatment was also found to be reduced significantly.

Author's Contribution

All authors have substantive intellectual contributions to this study.

Anupam Dutta contributed to the planning and conducting the study.

Dipjyoti Boruah contributed to the collection of data and preparation of the manuscript.

Angshuman Boruah contributed to statistical analysis.

Arijit Das contributed to the collection of data.

Statement of Institutional Review Board Approval

Research of the following manuscript has been approved and recommended by Institutional Ethics Committee (H), Assam Medical College, Dibrugarh. (Reg. No. ECR/636/Inst/AS/2014) on September 22, 2021. For authentication, the document of recommendation by institutional ethics committee has been attached in the PDF format.

Supplementary Material

Publication History

Article published online:
06 February 2023

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