Improving prospects for employment of the haemophiliac.

Abstract

The recent introduction of self-treatment has dramatically improved the management of severe haemophilia A and B (Christmas disease), and most sufferers in Britain can now inject themselves intravenously with factor VIII or IX con centrate whenever they suspect bleeding.1 This change in management has reduced dependence on hospital treatment, increased social independence and morale,2 and possibly will delay, if not prevent, the development of chronic haemophilic arthropathy.8 The potential effect, however, of this advance on employment prospects has yet to be determined. In previous studies on the employment of haemophiliacs4 6 the reported incidence of unemployment varied from 18% to 35% compared with a national unemployment rate of around 7%. It might be expected that improved treatment would increase employment prospects and help offset the approximate cost of ?2000 a patient a year for purchasing blood product concentrate. We describe a study of the factors that currently affect the employment prospects of the haemophiliac, together with an assessment of the impact of self-treatment.