7d8d82fb90c1216ea30ffea2204498d6 322745.pdf afa764db3401a29fb9a8deb0f137f5e8dec51d0f 322745.pdf 91e02622b895a63fe8f178c0086c70fedeac2cbc50e7a15c4c24bb597870c4c9 322745.pdf Title: Patient-Centred Management of Well-Controlled Haemophilia: Obtaining Opinions and Definitions Through a Delphi Consensus Subject: Background/Objectives: For people with haemophilia, health-related quality of life mainly depends on the arthropathy caused by repeated joint bleeding. Prophylaxis is the standard of care in patients with severe bleeding phenotypes, but globally, none of the measures used to assess patients’ outcomes consider their desires and life expectations. We propose the concept of the “patient-centred management of well-controlled haemophilia” to define individual responses to prophylaxis. The aims of this work are (1) to achieve agreement about the definition of the “patient-centred management of well-controlled haemophilia” by a steering committee of experts, and (2) to share a series of statements that should define the “patient-centred management of well-controlled haemophilia” with other haemophilia clinicians looking for a consensus in this scenario. Methods: An eight-expert group was established to define the concept of the “patient-centred management of well-controlled haemophilia”. Seven major aspects were identified, and a final version of 42 statements was established and distributed to a 75-expert panel for consensus gathering using the Delphi methodology. Results: Forty-eight experts participated in the first round (participation rate: 64%); two sentences from domain 3 were split, leading to a total of 44 statements across the seven domains. Consensus was achieved in 92.85% of cases. Five items and three statements advanced to the second round. Eleven statements were reconsidered in the second round (response rate: 100%). The questionnaire presented high internal consistency. Conclusions: New treatments offer promising solutions for patients, but there is a paucity of models to measure global outcomes. Patient-centred medicine requires multidimensional assessment, and the “patient-centred management of well-controlled haemophilia” concept is intended to enable this. 12pt Keywords: haemophilia; Delphi methodology; consensus; controlled patient; hemarthrosis; factor VIII deficiency; factor IX deficiency Author: Rubén Berrueco, Inmaculada Soto, José María Bastida, José Manuel Calvo Villas, Carmen de Cos, Saturnino Haya, Francisco Sierra García and José Mateo Arranz Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Fri May 9 11:15:48 2025 CEST ModDate: Fri May 9 11:50:27 2025 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 844856 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- PLOLAK+VnURWPalladioL Type 1 Custom yes yes yes 10 0 BNCDWE+URWPalladioL-Roma Type 1 Custom yes yes yes 16 0 DTICYU+URWPalladioL-Bold Type 1 Custom yes yes yes 22 0 ROODLG+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 CKBPVA+EURM10 Type 1 Builtin yes yes yes 59 0 KBHOHD+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 75 0 KBHOHF+PalatinoLinotype TrueType WinAnsi yes yes no 78 0 KBHOHH+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 81 0 KBHOMH+PalatinoLinotype TrueType MacRoman yes yes no 84 0 GQWIGS+CMSY10 Type 1 Builtin yes yes yes 92 0 CZOINJ+EURB10 Type 1 Builtin yes yes yes 100 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 105 0 KBHOHD+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 123 0 KBHOHE+PalatinoLinotype CID TrueType Identity-H yes yes yes 126 0 KBHOHF+PalatinoLinotype TrueType WinAnsi yes yes no 132 0 KBHOHH+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 135 0 KBHOMH+PalatinoLinotype TrueType MacRoman yes yes no 138 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-02-11 04:07:14 CET RepresentationInformation: 322745.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-02-10 09:45:55 CET Size: 844856 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 388 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Project Flowchart Destination: subsection.2.1 Item: Title: Expert Panel Destination: subsection.2.2 Item: Title: Data Management Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Internal Consistency of Questionnaire Destination: subsection.3.1 Item: Title: Consensus by Terciles Destination: subsection.3.2 Item: Title: Inter-Round Correlation Analysis Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Children: Item: Title: Disease Burden (See Supplementary Table S1, S1 S4) Destination: subsection.4.1 Item: Title: Pain Management (See Supplementary Table S1, S5 S13) Destination: subsection.4.2 Item: Title: Bleeding Control (See Supplementary Table S1, S14 S26) Destination: subsection.4.3 Item: Title: Adherence (See Supplementary Table S1, S27 S31) Destination: subsection.4.4 Item: Title: Patient Perspective (See Supplementary Table S1, S32 S34) Destination: subsection.4.5 Item: Title: Comorbidities (See Supplementary Table S1, S35 S38) Destination: subsection.4.6 Item: Title: Quality of Life (See Supplementary Table S1, S38 S42) Destination: subsection.4.7 Item: Title: Strengths and Limitations Destination: subsection.4.8 Item: Title: Implications and Clinical Relevance Destination: subsection.4.9 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Patient-Centred Management of Well-Controlled Haemophilia: Obtaining Opinions and Definitions Through a Delphi Consensus Author: Rubén Berrueco, Inmaculada Soto, José María Bastida, José Manuel Calvo Villas, Carmen de Cos, Saturnino Haya, Francisco Sierra García and José Mateo Arranz Subject: Background/Objectives: For people with haemophilia, health-related quality of life mainly depends on the arthropathy caused by repeated joint bleeding. Prophylaxis is the standard of care in patients with severe bleeding phenotypes, but globally, none of the measures used to assess patients’ outcomes consider their desires and life expectations. We propose the concept of the “patient-centred management of well-controlled haemophilia” to define individual responses to prophylaxis. The aims of this work are (1) to achieve agreement about the definition of the “patient-centred management of well-controlled haemophilia” by a steering committee of experts, and (2) to share a series of statements that should define the “patient-centred management of well-controlled haemophilia” with other haemophilia clinicians looking for a consensus in this scenario. Methods: An eight-expert group was established to define the concept of the “patient-centred management of well-controlled haemophilia”. Seven major aspects were identified, and a final version of 42 statements was established and distributed to a 75-expert panel for consensus gathering using the Delphi methodology. Results: Forty-eight experts participated in the first round (participation rate: 64%); two sentences from domain 3 were split, leading to a total of 44 statements across the seven domains. Consensus was achieved in 92.85% of cases. Five items and three statements advanced to the second round. Eleven statements were reconsidered in the second round (response rate: 100%). The questionnaire presented high internal consistency. Conclusions: New treatments offer promising solutions for patients, but there is a paucity of models to measure global outcomes. 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