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Author Notes:

Corresponding author: Duc Q. Tran, MD, Hemostasis/Thrombosis Program, School of Medicine, Emory University, 2015 Uppergate Drive 4th floor, Atlanta, Georgia, 30322 USA, dtranjr@emory.edu, Phone: 1-404-686-3494, Fax: 1-404-727-3681

DQT and CLK designed the research study.

DQT performed the research, analyzed the data, and wrote the manuscript.

VB, AA, MR, SS and CLK critically reviewed and edited the manuscript.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

DQT’s work was supported by the Bayer Hemophilia Award Program Fellowship Project Award.

DQT has received an honorarium from Novo Nordisk.

CLK receives research support from Novo Nordisk.

CLK has received honoraria from Baxter Biopharmaceuticals, Biogen Idec, Kedrion Biopharma, and CSL Behring.

VB, AA, MR, and SS have no interests which might be perceived as posing a conflict of interest or bias.


Research Funding:

DQT’s work was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR000454.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Hematology
  • adherence
  • depression
  • haemophilia
  • numeracy
  • physician trust
  • quality of life
  • HIV

Physician trust and depression influence adherence to factor replacement: a single-centre cross-sectional study


Journal Title:



Volume 23, Number 1


, Pages 98-104

Type of Work:

Article | Post-print: After Peer Review


Introduction: Poor adherence to factor replacement therapy among patients with haemophilia can lead to joint bleeding and eventual disability. Aim: The aim of this study was to determine patient-related characteristics associated with adherence to factor replacement in adults with haemophilia. Methods: Adults with haemophilia were recruited to participate in this cross-sectional study. Adherence was measured using either the Validated Hemophilia Regimen Treatment Adherence Scale (VERITAS)-Pro or the VERITAS-PRN questionnaire. Simple and multiple regression analyses that controlled for confounding were performed to determine the association between patient-related characteristics and adherence to factor replacement therapy. Results: Of the 99 subjects enrolled, all were men; 91% had haemophilia A and 78% had severe disease. Age ranged from 18 to 62 years. Most (95%) had functional health literacy; but only 23% were numerate. Mean adherence scores were 45.6 (SD 18) and 51.0 (SD 15) for those on a prophylactic and those on an episodic regimen, respectively, with a lower score indicating better adherence. On multivariable analysis, being on any chronic medication, longer duration followed at our haemophilia treatment centre, higher physician trust and better quality of life were associated with higher adherence. A history of depression was associated with lower adherence. Conclusion: Two potentially modifiable characteristics, physician trust and depression, were identified as motivator and barrier to adherence to factor replacement therapy. Promoting a high level of trust between the patient and the healthcare team as well as identifying and treating depression may impact adherence to factor replacement therapy and accordingly reduce joint destruction.

Copyright information:

© 2016 John Wiley & Sons Ltd.

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