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Status unknownNCT04775888PHAREOUpdated May 14, 2021

Accessibility of Prophylaxis and On-demand Treatment for Persons With Haemophilia and Other Coagulation Deficiencies

An observational study in Health Services Accessibility and Blood Coagulation Factor Deficiencies, sponsored by RESCUe - RESeau Cardiologie Urgence / RESUVal - RESeau des Urgences de la vallée du Rhône. Status unknown at 34 sites in France. Per ClinicalTrials.gov, last updated 2021-05-14.

Sponsored by RESCUe - RESeau Cardiologie Urgence / RESUVal - RESeau des Urgences de la vallée du Rhône · Observational

The sponsor has not verified this record recently (last verified Feb 2021), so the status shown — last known as Recruiting — may be out of date.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
500
Sex
All
01

Study summary

The current treatment of people with haemophilia and other bleeding deficiencies is largely based on clotting factor replacement therapy. The injections can be repeated several times a week according to a personalized schedule. To date, medications are exclusively dispensed in hospital pharmacies to ensure traceability and safety. This retrocession imposes accessibility constraints on patients and on their caregivers, increasing the burden of the disease, particularly in the organization of personal and professional daily life. The PHAREO study aims to investigate patients' perception of accessibility to anti-haemophilia drugs in relation to an evaluation of spatial accessibility in the Auvergne-Rhône-Alpes region (France) in order to consider, if necessary, ways of improving the pathway for patients and their caregivers.

Read the detailed description

Haemophilia is a rare constitutional hemorrhagic disease whose drug management is based on the use of chronic lifelong replacement therapy. For many years, the reference treatment, particularly in children, has been based on the use of anti-haemophilic drugs for prophylaxis requiring repeated injections several times a week according to a personalized schedule. In contrast, on-demand treatment is less and less used, particularly in patients with severe forms of haemophilia. Clinical and biological diagnosis, as well as the implementation and monitoring of treatments, are carried out within specialized hospital care structures affiliated with the French national reference center. Medications are dispensed as part of hospital retrocessions. This organization imposes constraints on patients and their caregivers due to their limited accessibility.

The burden related to this disease is probably due to the systematic use of specialized hospital teams such as doctors, nurses for self-injection training for example, and pharmacists. It now seems important to reflect on the evolution of patient pathways that were previously exclusively hospital-centred towards ambulatory care. To do this, various reflections need to be undertaken, including that relating to the accessibility of medication. Indeed, the monthly renewals of these chronic treatments force patients and their caregivers, as well as the parents of children, to go to the hospital, which frequently makes the organization of daily and professional life more cumbersome.

The PHAREO study aims to investigate patients' perception of accessibility to anti-haemophilia drugs in relation to an evaluation of spatial accessibility in order to consider, if necessary, ways of improving the pathway for patients and their caregivers.

The expected benefits of the study are to have: 1) an exhaustive description of the spatial accessibility of the cohort of people living with haemophilia to anti-haemophilia medication within the Auvergne Rhône Alpes region (France) and 2) a better understanding of their needs and their perceptions regarding access to on-demand and prophylactic treatments.

02

Conditions studied

  • Health Services Accessibility
  • Blood Coagulation Factor Deficiencies

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Keywords

  • haemophilia
  • accessibility
  • on-demand treatment
  • prophylactic treatment
03

In context

Hemophilia A

866 studies on the registry are indexed under Hemophilia A; 137 are open to participants now.

This study's planned enrollment of 500 is above the median of 80 across 314 observational studies indexed under Hemophilia A.

Browse Hemophilia A studies →

Lead sponsor

RESCUe - RESeau Cardiologie Urgence / RESUVal - RESeau des Urgences de la vallée du Rhône is the lead sponsor of 2 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The included subjects comprise people with haemophilia or other coagulation deficiencies, with no limitation of age, treated by prophylaxis or on-demand treatment, in one of the authorized hospital pharmacies in the Auvergne-Rhone-Alpes region (France).

Eligibility criteria

Included:

  • Living person on the study start date and presenting with haemophilia or other coagulation deficiencies;
  • Treated with prophylaxis or on-demand anti-haemorrhagic treatments;
  • Location of medication dispensing within the hospital pharmacies of the HEsora network (Hémophilie Soins Rhône Alpes): 27 eligible hospital pharmacies in Rhône Alpes + \<10 eligible hospital pharmacies in Auvergne

Excluded:

  • Home delivery (not included in the study via hospital pharmacy)
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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
500 participants (estimated)
Patient registry
No
06

What researchers measure

Primary outcomes

  1. To assess the perception of persons with haemophilia and other coagulation deficiencies regarding the accessibility to prophylactic and on-demand antihemorrhagic treatment

    The perception is defined by the satisfaction level of the survey participants, measured with on item in the questionnaire (Very satisfied / Rather satisfied / Rather not satisfied / Not satisfied).

    Time frame: Through study completion, on average 6 months.

  2. To measure the accessibility of persons with haemophilia and other coagulation deficiencies regarding the accessibility to prophylactic and on-demand antihemorrhagic treatment

    The accessibility is measured by spatial analysis, representing the distance between the home and/or work zip codes and the hospital pharmacy zip code.

    Time frame: Through study completion, on average 6 months.

  3. To compare the perception and the spatial accessibility of persons with haemophilia and other coagulation deficiencies regarding prophylactic and on-demand antihemorrhagic treatment

    The mean distances between the 4-groups of satisfaction level are compared using an analysis of variance (ANOVA).

    Time frame: Through study completion, on average 6 months.

Secondary outcomes

  1. To determine if the severity of the disease would be a factor for encouraging or limiting the perception of accessibility to prophylactic or on-demand anti-haemorrhagic treatments

    The satisfaction level of participants are stratified on the severity of the disease (minor, moderate, major).

    Time frame: Through study completion, on average 6 months.

  2. To determine if the age of the patient would be a factor for encouraging or limiting the perception of accessibility to prophylactic or on-demand anti-haemorrhagic treatments

    The satisfaction level of participants are stratified on the age of patient.

    Time frame: Through study completion, on average 6 months.

  3. To determine if the condition of access to hospital would be a factor for encouraging or limiting the perception of accessibility to prophylactic or on-demand anti-haemorrhagic treatments

    The satisfaction level of participants are stratified on the condition of access to hospital (relative to traffic conditions, the physical condition of the patient, the parking difficulties).

    Time frame: Through study completion, on average 6 months.

  4. To determine if the level of autonomy of the participant would be a factor for encouraging or limiting the perception of accessibility to prophylactic or on-demand anti-haemorrhagic treatments

    The satisfaction level of participants are stratified on the level of autonomy of the participant (relative to wheelchair, crutch/walking stick or other mobility aid).

    Time frame: Through study completion, on average 6 months.

  5. To determine if the availability of the hospital pharmacy would be a factor for encouraging or limiting the perception of accessibility to prophylactic or on-demand anti-haemorrhagic treatments

    The satisfaction level of participants are stratified on the availability of the hospital pharmacy (relative to the waiting times).

    Time frame: Through study completion, on average 6 months.

07

Study locations

34 of 34 sites recruiting
  • Centre Hospitalier Albertville-Moûtiers
    Albertville, 73200, France
    • Thomas Gailland · Contact
    Recruiting
  • Centre Hospitalier Annecy Genevois
    Annecy, 74370, France
    • Christelle Roch · Contact
    Recruiting
  • Centre Hospitalier d'Ardèche Nord
    Annonay, 07103, France
    • Sophie Vernardet · Contact
    Recruiting
  • Centre Hospitalier d'Ardèche Méridionale
    Aubenas, 07200, France
    • Alain Lenoir · Contact
    Recruiting
  • Centre Hospitalier Henri Mondor d'Aurillac
    Aurillac, 15000, France
    • Valérie Millot · Contact
    Recruiting
  • Centre Hospitalier de Belley
    Belley, 01300, France
    • Marie Geneste · Contact
    Recruiting
  • Centre hospitalier de Bourg St Maurice
    Bourg St Maurice, 73700, France
    • Valérie Chaminant · Contact
    Recruiting
  • Centre Hospitalier Fleyriat
    Bourg-en-Bresse, 01012, France
    • Stéphanie Claveranne · Contact
    Recruiting
  • Centre Hospitalier Pierre Oudot
    Bourgoin-Jallieu, 38300, France
    • Clément Beyron · Contact
    Recruiting
  • Groupement Hospitalier Est, Hospices Civils de Lyon
    Bron, 69500, France
    • Valérie Chamouard · Contact
    Recruiting
  • Centre Hospitalier de Chambéry - Hôpital Savoie
    Chambéry, 73000, France
    • Elodie Bernard · Contact
    Recruiting
  • Centre Hospitalier Universitaire de Clermont-Ferrand
    Clermont-Ferrand, 63100, France
    • Anne Boyer · Contact
    Recruiting
  • Centre Hospitalier Alpes Léman
    Contamine-sur-Arve, 74130, France
    • Catherine Diakhate · Contact
    Recruiting
  • Hôpital Nord Ouest de Villefranche-sur-Saône
    Gleizé, 69400, France
    • Magali Bourdelin · Contact
    Recruiting
  • Centre Hospitalier Universitaire Grenoble - Alpes
    La Tronche, 38700, France
    • Sophie Cerena · Contact
    Recruiting
  • Hôpital Edouard herriot, Hospices Civils de Lyon
    Lyon, 69003, France
    • Elodie Lanoi · Contact
    Recruiting
  • Hôpital de la Croix-Rousse, Hospices Civils de Lyon
    Lyon, 69004, France
    • Anne-Claire Uhrès · Contact
    Recruiting
  • Centre Hospitalier du Forez
    Montbrison, 42600, France
    • Hadyl Asfari · Contact
    Recruiting
  • Hôpital de Montluçon
    Montluçon, 03100, France
    • Carole Rimpici · Contact
    Recruiting
  • Centre Hospitalier de Montélimar
    Montélimar, 26200, France
    • Jérémy Rolain · Contact
    Recruiting
  • Centre Hospitalier de Moulins-Yzeure
    Moulins, 03006, France
    • Emmanuel Deligeard · Contact
    Recruiting
  • Centre Hospitalier Du Haut Bugey
    Oyonnax, 01100, France
    • Nathalie Dey · Contact
    Recruiting
  • Centre Hospitalier des Vals d'Ardeche
    Privas, 07007, France
    • Dominique Quinard · Contact
    Recruiting
  • Centre Hospitalier de Roanne
    Roanne, 42300, France
    • Maud Rossignol · Contact
    Recruiting
  • Hôpitaux Drôme Nord
    Romans-sur-Isère, 26100, France
    • Xavier Cussoneau · Contact
    Recruiting
  • Pharmacie Centrale, Hospices Civils de Lyon
    Saint-Genis-Laval, 69230, France
    • Isabelle Carpentier · Contact
    Recruiting
  • Centre Hospitalier Intercommunal Sud-Léman Valserine
    Saint-Julien-en-Genevois, 74164, France
    • Alexandra Combes · Contact
    Recruiting
  • Centre Hospitalier Uuniversitaire Nord, Saint-Étienne
    Saint-Priest-en-Jarez, 42270, France
    • Jihen Boussetta · Contact
    Recruiting
  • Hôpitaux du Pays du Mont-Blanc
    Sallanches, 74700, France
    • Marion Filippi · Contact
    Recruiting
  • Hôpital Nord-Ouest Tarare-Grandris
    Tarare, 69170, France
    • Christine Vray · Contact
    Recruiting
  • Hopitaux du Léman
    Thonon-les-Bains, 74203, France
    • Denis Hardelin · Contact
    Recruiting
  • Centre Hospitalier de Valence
    Valence, 26000, France
    • Stéphanie Bourget · Contact
    Recruiting
  • Centre Hospitalier de Vichy
    Vichy, 03200, France
    • Jérôme Tavernier · Contact
    Recruiting
  • Centre Hospitalier Lucien Hussel
    Vienne, 38200, France
    • Anne-Sophie Leromain · Contact
    Recruiting
08

References and documents

Publications

  • Leroy V, Freyssenge J, Renard F, Tazarourte K, Negrier C, Chamouard V. Access to treatment among persons with hemophilia: A spatial analysis assessment in the Rhone-Alpes region, France. J Am Pharm Assoc (2003). 2019 Nov-Dec;59(6):797-803. doi: 10.1016/j.japh.2019.07.006. Epub 2019 Aug 9. PubMed 31405805 ↗
  • Susen S, Gruel Y, Godier A, Harroche A, Chambost H, Lasne D, Rauch A, Roullet S, Fontana P, Goudemand J, de Maistre E, Chamouard V, Wibaut B, Albaladejo P, Negrier C. Management of bleeding and invasive procedures in haemophilia A patients with inhibitor treated with emicizumab (Hemlibra(R) ): Proposals from the French network on inherited bleeding disorders (MHEMO), the French Reference Centre on Haemophilia, in collaboration with the French Working Group on Perioperative Haemostasis (GIHP). Haemophilia. 2019 Sep;25(5):731-737. doi: 10.1111/hae.13817. Epub 2019 Jul 11. PubMed 31294904 ↗

Individual participant data

Plan to share: No — Patient information is held under legal and ethical obligations of confidentiality. As the disease is rare, information should not be used or disclosed in a form that might identify a patient without his or her consent.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 14, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04775888
Lead sponsor
RESCUe - RESeau Cardiologie Urgence / RESUVal - RESeau des Urgences de la vallée du Rhône
Collaborators
Hospices Civils de Lyon
Responsible party
Sponsor
First posted
Mar 1, 2021
Start date
Sep 21, 2020
Primary completion
Apr 30, 2021
Completion
May 21, 2021 (estimated)
Last update
May 14, 2021

Study contacts

Valérie Chamouard, PharmD
Contact
valerie.chamouard@chu-lyon.fr
+33(0)472118829
Carlos El Khoury, MD, PhD
Contact
c.elkhoury@resuval.fr
+33(0)437021059
Laurie Fraticelli, PhD
study director · RESCUe-RESUVal
Julie Freyssenge, PhD
study director · RESCUe-RESUVal

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.

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