Health Care Decisions Research Articles

Disclosure Practices in Muslim Patients and the Impact on End-of-Life Care: A Narrative Review.

Context: Non-disclosure practices hold significant weight in end-of-life care for Muslim communities, where cultural and religious beliefs are deeply intertwined with healthcare decision-making. This narrative review explores the complexities of medical decision-making and disclosure practices among terminally ill Muslim patients, examining how these factors shape palliative care delivery. Objectives: The primary objective of this review is to investigate the impact of non-disclosure practices on end-of-life care in Muslim populations, focusing on key themes that influence medical decision-making. Additionally, the review identifies ways in which Healthcare Provider (HCP) can navigate these culturally sensitive issues to enhance care. Methods: A comprehensive narrative review was conducted, utilizing articles from CINHAL, PsychINFO, Scopus, and PubMed databases published between 2009 and 2024. An initial search yielded 2025 articles. After applying inclusion and exclusion criteria, 12 studies were included for analysis. The SANRA guidelines for narrative reviews were followed, and the SPIDER framework was used for qualitative synthesis. Results: Of the 2041 articles initially retrieved, 2014 were excluded after screening, 8 were duplicates, and 7 full texts were excluded for not meeting the inclusion criteria. The final review included 12 studies. Three key themes emerged: (1) cultural, religious, and emotional factors driving requests for non-disclosure, (2) the prominent role of family in medical decision-making, and (3) healthcare provider communication challenges contributing to disparities in palliative care access. Conclusion: Non-disclosure practices present significant barriers to effective palliative care in Muslim communities. To improve care outcomes, culturally competent communication strategies and family-centered decision-making models are crucial.

Cost-effectiveness analysis of anticoagulation options for non-valvular atrial fibrillation in Iran

BackgroundAtrial fibrillation (AF) imposes a substantial economic and clinical burden, particularly in developing countries like Iran. This study aimed to evaluate the cost-effectiveness of anticoagulation options for non-valvular atrial fibrillation (NVAF) in Iran.MethodsWe conducted a cost-effectiveness analysis comparing warfarin, apixaban, dabigatran 110 mg, dabigatran 150 mg, and rivaroxaban for NVAF patients from the Iranian payer’s perspective. A Markov model with a lifetime horizon was used to estimate costs and quality-adjusted life years (QALYs). The model incorporated clinical event rates, case-fatality rates, and utility values. Uncertainty was assessed using deterministic sensitivity analysis and probabilistic sensitivity analysis.ResultsAmong the interventions, warfarin had the lowest cost ($1,755) but apixaban resulted in the highest QALYs (7.33). Apixaban was the most cost-effective strategy with an incremental cost-effectiveness ratio (ICER) of $2,026 per QALY gained compared to warfarin. Apixaban dominated other treatments, with lower costs and higher QALYs. Probabilistic sensitivity analysis indicated that at Iran’s willingness-to-pay threshold of $4,387 per QALY gained, apixaban had a high probability of being cost-effective (88.2%).ConclusionOur study provides strong evidence for healthcare decision-makers in Iran, showing that apixaban is a cost-effective treatment for NVAF, potentially enhancing patient outcomes and optimizing healthcare expenditures.

Experiences and Perspectives of the COVID-19 Pandemic and Vaccinations in Culturally and Linguistically Diverse (CALD) Populations in Australia: A Qualitative Study.

Qualitative research surrounding the impacts of COVID-19 and vaccine hesitancy has been extensively studied in the European context; however, limited research has been conducted within communities in the Australian context. This research paper highlights the issues experienced by culturally and linguistically diverse (CALD) members during the COVID-19 pandemic and vaccination rollout. The purpose of this study is to strengthen our understanding of the challenges experienced by CALD communities and enable healthcare policies to be developed and implemented to prevent these communities from being disadvantaged in a healthcare crisis.The methods of this study include focus group sessions with 12 participants from CALD backgrounds across different states including Victoria, Northern Territory, and Queensland. They were divided into two separate Zoom sessions and aimed to amplify the voices in Victoria, as the state had the nation's longest and most challenging COVID-19 lockdown laws. Key findings of the study highlighted the language barriers, racism, and lack of cultural awareness experienced among CALD communities during the pandemic. Additionally, there was a significant division in views and experiences within CALD communities and families. Social media played a prominent role in dividing the perceptions and understanding of health information during the pandemic. Participants were motivated to be vaccinated due to workplace protocols or to protect their family members and move toward normality. Lastly, the government's mandatory vaccination policies limited personal choice, resulting in a loss of skilled workers and pressured some participants into making healthcare decisions within a limited period of time. The study's findings reflect that the CALD communities and families were disproportionately impacted during the COVID-19 pandemic and vaccination rollout, further highlighting and adding to the health inequities among CALD communities in Australia.

A survey of the legal frameworks on medical decision-making in minors in European countries.

This study examines how healthcare decisions involving minors are handled across European countries by asking member organizations of the European Academy of Paediatrics (EAP).An online survey was distributed via the EAP network to representatives of national paediatric associations in all European countries. The survey focused on determining the age at which minors can consent to medical treatment without parental permission, including contexts such as mental health treatment, reproductive health, vaccinations, life-threatening situations, and end-of-life decisions. Responses were collected, analysed, and validated through follow-up checks with the respondents. We received 62 responses from 43 countries. The minimum age at which minors can consent to medical treatment varies substantially across Europe, ranging from sixteen or eighteen years in some countries to being based on the child's maturity in others. Additionally, there are disparities in the age of consent across specific contexts; for example, end-of-life decisions for minors are prohibited in several countries.Conclusions: In 2024, substantial differences persist in the legal age at which minors can make healthcare decisions across Europe. These findings are pertinent for policymakers and healthcare providers aiming to develop regulations that uphold the rights of young people while ensuring ethical, patient-centered care in a diverse continent but with easy movement and migration across internal borders. Future research should investigate how European health systems adapt to changes in healthcare requirements as a child grows and matures, and the impact of EU policies on paediatric healthcare services. What is Known? • Prior research has established that the age at which minors can consent to medical treatment varies internationally. •Across European countries, legal ages for minor consent to medical treatment continue to show substantial variance, reflecting differing national policies and cultural attitudes towards the autonomy of young individuals. What is New? •This study uniquely highlights that not only does the age of consent differ across countries. • The age of consent varies across different medical contexts, such as mental health, reproductive health, and end-of-life decisions.

Exploring the relationship between website quality and equity in living donor kidney transplant.

Health system websites are important resources to guide health care decisions and may be useful tools to improve racial equity in access to living donor kidney transplant (LDKT). We performed a cross-sectional study of adult LDKT programs in the United States. We created an assessment tool for website quality across three domains: accessibility (access to LDKT specific information from the transplant center website), readability (ease of reading and clarity), and educational content (appropriateness and presentation of information, LDKT-specific content, program-specific characteristics, and adherence to equity-centered principles of web design). Among the 185 transplant center websites reviewed, only 14.6% of LDKT sites could be accessed directly from the transplant center webpage. The median suitability assessment of materials (SAM)-a validated measure of website content for chronic kidney disease (CKD)-was 45 out of 86 (IQR 4) and the median Flesch-Kincaid grade level and ease score were 9.1 (IQR 0.8) on a scale of 0-18 and 51.2 (IQR 5) on a scale of 0-100, respectively. These results indicate that LDKT websites are currently not available, accessible, and understandable for many potential transplant candidates and donors. Optimizing the content and design of transplant center websites may be a promising and effective strategy for improving equity in access to LDKT.

Multi-Criteria Decision Analysis for healthcare decisions: a bibliometric study

Healthcare has a direct impact on human life and involves risk factors, uncertainties and preferences. The complexity and implications of actions in this area and the demand for rational and transparent decision processes has resulted in the widespread use of Multi-Criteria Decision Analysis (MCDA) methods. As such, this study aimed to conduct a bibliometric analysis of the literature on the use of MCDA in healthcare, as well as analyzing the reasons presented in the articles for selecting MCDA methods, when applicable. The study analyzed 195 articles in the Scopus and PubMed databases between 1991 and 2019. The results were presented in graphs that focused on the main objectives of the study, highlighting the fact that only 28% of the articles presented justifications for the methods chosen. Many of the justifications were not well founded. It was concluded that care is needed to ensure appropriate selection of multi-criteria methods.

Sustainable Health and Well-Being: Guidelines for Integrating Therapeutic Gardens for Holistic Hospital Care

Therapeutic hospital gardens (THGs) need to be purposefully designed for hospital users and well-integrated into the clinical hospital treatment plan to be effective. Healthcare decision-makers are critically important in establishing therapeutic gardens in hospitals and healthcare facilities because they have the ultimate decision-making power to include such gardens for the holistic care of their patients, staff, and visitors. This study aims to establish how THGs can be successfully created by investigating the professional experiences of 12 global healthcare decision-makers in hospital administration, executive government, and senior consultancy to government on the role of THGs in creating a healthy and sustainable hospital environment. This article shows how these decision-makers, who have already worked with healthcare designers and clinical practitioners to design and establish THGs, have been selected and interviewed. The qualitative analysis of these semi-structured interviews uncovered why and how these healthcare decision-makers made THGs a reality in their hospitals. This analysis informed the development of the THG Healthcare Decision-maker Guidelines, which were designed to guide all hospital CEOs, government executives, and senior consultants to the government to both design and then establish THGs successfully. These guidelines include five systematic steps: 1. design for hospital cohorts; 2. purposefully design and integrate THGs well; 3. facilitate inclusive and defined stakeholder engagement; 4. evaluate the garden visitor experience; and 5. understand the benefits and values of THGs. These five systematic steps can be used immediately by healthcare decision-makers to work with healthcare designers and clinical experts to implement such gardens in hospitals successfully. When the three sectors, healthcare governance, healthcare design, and clinical health, work together, more THGs can be established in hospitals for better patient care, visitor well-being, and a healthy and sustainable hospital environment.

Assessing Health Literacy, Learning Needs, and Patient Satisfaction in Cancer Care: A Holistic Study in the Omani Context

Background: Health literacy is essential in cancer care, affecting patient outcomes, perception, and involvement in healthcare decisions. Purpose: This study aimed to evaluate and identify gaps and relationships between the levels of health literacy, learning needs, and satisfaction with educational activities among cancer patients in Oman. Methods: A cross-sectional study was conducted among 323 cancer patients at the Sultan Qaboos Comprehensive Cancer Center, University Medical City, in Muscat, Oman. Data were collected using a self-administered questionnaire, which measured health literacy using the Health Literacy Instrument for Adults (HELIA), assessed learning needs based on importance, and evaluated satisfaction with educational activities. Descriptive statistics and correlation analyses were conducted using SPSS version 23 to identify relationships between the variables. Results: The average health literacy score was 4.36, indicating a generally high level of health literacy among the participants. Learning needs were highest for chemotherapy and hormonal therapy (mean = 4.65), while satisfaction with education activities was highest for overall experience (mean = 4.38). However, there were notable gaps between the perceived importance of learning needs and satisfaction with educational activities, particularly in chemotherapy and hormonal therapy (gap = 0.46). A moderate positive correlation was found between health literacy and learning needs (r = 0.341, p = 0.022), while a stronger positive correlation existed between health literacy and satisfaction with educational activities (r = 0.58, p < 0.00001). Conclusion: Improving health literacy and addressing gaps in learning needs and educational satisfaction are crucial for enhancing cancer care outcomes and patient satisfaction in Oman.

FANE

In today's society, the continuous exchange of vast amounts of information, often irrelevant or misleading, highlights the need for greater awareness to distinguish between accurate and false information. Recognizing the reliability of information is critical to limiting the spread of fake news, a pervasive problem affecting various sectors, influencing public opinion, and shaping decisions in health care, politics, culture, and history. This paper proposes a methodology to assess the veracity of information, leveraging natural language processing (NLP) and probabilistic models to extract relevant features and predict the reliability of content. The features analyzed include semantic, syntactic, and social dimensions. The proposed methodology was tested using datasets that include social media news and comments captured during the lockdown due to COVID-19, providing relevant context for the analysis. Experimental validation of these different datasets yields promising results, demonstrating the effectiveness of the proposed approach.

Weight-Based Privacy-Preserving Asynchronous SplitFed for Multimedia Healthcare Data

Multimedia significantly enhances modern healthcare by facilitating the analysis and sharing of diverse data, including medical images, videos, and sensor data. Integrating AI for multimedia data classification shows promise in improving healthcare services, data analysis, and decision-making. However, ensuring privacy in AI-integrated healthcare systems remains a challenge, especially with data continuously transmitted over networks. Synchronous Federated Learning (FL) is designed to address these privacy concerns by allowing end devices to collaboratively train a machine learning model without sharing data. Nonetheless, FL alone does not fully resolve privacy issues and faces efficiency challenges, particularly with devices of varying computational capabilities. In this article, we introduce an Asynchronous Partial Privacy-preserving Split-Federated Learning (APP-SplitFed) approach for smart healthcare systems. This method reduces computational demands on resource-limited devices and uses a weight-based aggregation method to allow devices of differing computational power to contribute effectively, ensuring optimal model performance and rapid convergence. Additionally, we incorporate a secure aggregation method to prevent adversaries from identifying individual models owned by healthcare institutions.

Revisiting the need for intellectual and moral virtues in making ethical decisions in Healthcare.

Patient-physician interaction is an essential factor influencing the patient's health management decisions. This communication allows the patients to develop trust in the treating physicians and facilitates them in deciding what's best for themselves. The physicians, on the other hand, may interact with the patients based on three moral philosophies i.e. as a part of their duty (deontology), as a part of anticipating consequences (consequentialism) and as a part of being a virtuous doctor (virtue ethics). In this communication, we aim to debate the need and utility of having moral virtues for ethical decision-making. We will also evaluate the role of intellectual virtues in patient-doctor interaction for decisions taken on clinical grounds.

Health-related quality of life and its association with socioeconomic status and mental health in 5- to 7-year-old children: a cross-sectional study.

Assessing socioeconomic status (SES), mental health, and health-related quality of life (HRQoL) in young children is crucial for making informed health care decisions and identifying areas of intervention. The present study aimed to investigate potential associations between SES, mental health, and HRQoL in 5-7-year-old children. The present study included mother-reported health assessments for 621 children aged 5-7years in Grade 1 collected between 2019 and 2023 as part of the Starting Right™ project. Online questionnaires were used to support public health nurses in assessing children's health status. HRQoL (KIDSCREEN-27, 5 subscales) and mental health [Strength and Difficulties Questionnaire (SDQ), 4 subscales] were assessed. Sociodemographic characteristics, sex, maternal education, and income were obtained from Statistics Norway. The data were analyzed using multiple robust regression. Mother-reported mean scores for the KIDSCREEN-27 were within the normal range compared with European norms (8-11years). However, for each KIDSCREEN-27 dimension, there were individuals whose mothers reported scores that were substantially lower than average. Having mental health problems, defined as being in the 80th and 90th percentiles of the SDQ Total problem score, was associated with 2.1-10.7-point lower KIDSCREEN-27 scores (p < 0.001-0.021), which was most noticeable in the KIDSCREEN-27 school environment subscale. Weak but significant positive associations were found between SES and HRQoL. Our results provide important insights into the associations between SES, mental health, and HRQoL in young children. Given the strong association between mental health problems and HRQoL in Grade 1 children, the assessment of both is essential, so that early interventions, an improved caring environment, and nurturing support can be initiated.

Defining the Cost of Arthroscopic Rotator Cuff Repair

Background: Rotator cuff repair (RCR) is a frequently performed outpatient orthopaedic surgery, with substantial financial implications for health-care systems. Time-driven activity-based costing (TDABC) is a method for nuanced cost analysis and is a valuable tool for strategic health-care decision-making. The aim of this study was to apply the TDABC methodology to RCR procedures to identify specific avenues to optimize cost-efficiency within the health-care system in 2 critical areas: (1) the reduction of variability in the episode duration, and (2) the standardization of suture anchor acquisition costs. Methods: Using a multicenter, retrospective design, this study incorporates data from all patients who underwent an RCR surgical procedure at 1 of 4 academic tertiary health systems across the United States. Data were extracted from Avant-Garde Health’s Care Measurement platform and were analyzed utilizing TDABC methodology. Cost analysis was performed using 2 primary metrics: the opportunity costs arising from a possible reduction in episode duration variability, and the potential monetary savings achievable through the standardization of suture anchor costs. Results: In this study, 921 RCR cases performed at 4 institutions had a mean episode duration cost of $4,094 ± $1,850. There was a significant threefold cost variability between the 10th percentile ($2,282) and the 90th percentile ($6,833) (p &lt; 0.01). The mean episode duration was registered at 7.1 hours. The largest variability in the episode duration was time spent in the post-acute care unit and the ward after the surgical procedure. By reducing the episode duration variability, it was estimated that up to 640 care-hours could be saved annually at a single hospital. Likewise, standardizing suture anchor acquisition costs could generate direct savings totaling $217,440 across the hospitals. Conclusions: This multicenter study offers valuable insights into RCR cost as a function of care pathways and suture anchor cost. It outlines avenues for achieving cost-savings and operational efficiency. These findings can serve as a foundational basis for developing health-economics models. Level of Evidence: Economic and Decision Analysis Level III. See Instructions for Authors for a complete description of levels of evidence.

The health information management professionals' role in supporting individuals considering genetic testing: An exploratory study.

Background: An increasing number of people are exploring their genetic predisposition to many diseases, allowing them to make healthcare decisions with improved knowledge. Objectives: The aim of this study was to identify factors that influence individuals to consider genetic testing utilising a modified health belief model (HBM). Method: The authors tested the modified HBM using a convenience sample of individuals from across the United States after a pilot study was used to test the validity and reliability of the constructs. Using SmartPLS, the researchers determined that the modified HBM explains the decision-making process used to determine what influences individuals to consider genetic testing. Results: Results suggested that perceived susceptibility, perceived benefits, cues to action, self-efficacy, e-health literacy and normative belief all play a role in an individual's decision to test their genetics. Conclusion: By conducting genetic testing, individuals may benefit from knowing they are predisposed to certain cancers and other diseases. Yet, research results have indicated that most individuals are unaware of resources available online that will help them in understanding genetic test results and associated diseases. Implications: Since healthcare literacy is an issue reported by these individuals, health information management professionals are well qualified to support them in e-health literacy by assisting them to evaluate the trustworthiness of available resources, and to educate them about privacy rights regarding access to and protection of their genetic information.

Mapping the Landscape of Generative Language Models in Dental Education: A Comparison Between ChatGPT and Google Bard.

We developed seven dental education-related queries to assess each model across various domains: their role in dental education, creation of specific exercises, simulations of dental problems with treatment options, development of assessment tools, proficiency in dental literature and their ability to identify, summarise and critique a specific article. Two blind reviewers scored the responses using defined metrics. The means and standard deviations of the scores were reported, and differences between the scores were analysed using Wilcoxon tests. ChatGPT 3.5 outperformed Bard in several tasks, including the ability to create highly comprehensive, accurate, clear, relevant and specific exercises on dental concepts, generate simulations of dental problems with treatment options and develop assessment tools. On the other hand, Bard was successful in retrieving real research, and it was able to critique the article it selected. Statistically significant differences were noted between the average scores of the two models (p ≤ 0.05) for domains 1 and 3. This study highlights the potential of LLMs as dental education tools, enhancing learning through virtual simulations and critical performance analysis. However, the variability in LLMs' performance underscores the need for targeted training, particularly in evidence-based content generation. It is crucial for educators, students and practitioners to exercise caution when considering the delegation of critical educational or healthcare decisions to computer systems.

Impact of the COVID-19 pandemic on intra-household gender disparities in the Middle East and North Africa region: A scoping review protocol.

The Middle East and North Africa (MENA) is a global outlier both for its low female labor force participation and investment in early childhood development services, and consistently ranks lowest on global rankings of gender parity. While the impact of the COVID-19 pandemic on global gender inequity has been acknowledged, specific challenges faced by partnered-women in MENA are underexplored. Additionally, with over half of the region affected by conflict and displacement, exploring these impacts sheds light on understudied gender disparities in humanitarian contexts during the pandemic. This scoping review aims to examine intra-household gender disparities during the COVID-19 pandemic, adding to a more comprehensive understanding of this particular public health emergency's worldwide ramifications. The hypothesis is that the pandemic has exacerbated women's pre-existing constraints in the MENA region, worsening gender inequities in economic empowerment, healthcare access, and general well-being. This review will explore intra-household gender disparities in decision-making, household labor division, economic independence, health, and access to resources and services during the COVID-19 pandemic that have been reported to have been affected by COVID-19 globally. Following PRISMA guidelines for Scoping Reviews, a comprehensive search will be conducted in APA PsycINFO, Arab World Research Source: Al Masdar, EconLit, Global Health, MEDLINE, Scopus, and Web of Science Core Collection, in consultation with an information specialist. Studies in English, French and Arabic from January 2020 to August 2024 will be included. Four independent reviewers will screen studies, and data will be charted, coded, and narratively synthesized. This review is expected to shed light on gender disparities in healthcare accessibility, mobility, and decision-making during the COVID-19 pandemic across low- and middle-income countries in the MENA region, adding to the global literature.

Methodological literature on the reporting of systematic reviews of health economic evaluations: a scoping review protocol

Systematic reviews of health economic evaluations play a crucial role in informing evidence-based healthcare decisions, yet they lack standardized reporting guidelines. A project has been initiated that aims to extend the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline for systematic reviews of health economic evaluations (PRISMA-EconEval). This scoping review forms a foundation for the PRISMA-EconEval project, aiming to identify, map, and extract candidate reporting items from the methodological literature. The scoping review will follow the PRISMA Extension for Scoping Reviews (PRISMA-ScR) Checklist and involve comprehensive searches in databases such as PubMed MEDLINE, Embase, and Web of Science, covering the period from 2015 to 2024. Supplementary searching, reference checking and citation searching will target grey literature, overlooked studies and evidence prior to 2015. Inclusion criteria will focus on methodological papers that provide frameworks or recommendations for reporting systematic reviews of health economic evaluations and enhanced case studies that critically discuss methods and reporting structures. The extracted data will be coded and analyzed to produce an initial list of candidate reporting items, structured according to conventional sections of a systematic review (e.g., title, abstract, methods, results). This initial list will be used in the subsequent stages of the project and disseminated through a peer-reviewed publication and presentations at international conferences. The outcome of this scoping review will significantly contribute to the development of a comprehensive PRISMA-EconEval reporting guideline, aimed at enhancing the transparency, consistency, and quality of systematic reviews of health economic evaluations, and provide an essential tool for authors, editors, peer-reviewers, and stakeholders.

Health Diagnostic Assistant using LLMs

The Health Diagnostic Assistant leverages advanced Large Language Models (LLMs) and Natural Language Processing (NLP) techniques to enhance patient diagnosis and healthcare decision-making. This innovative system employs Retrieval-Augmented Generation (RAG) to combine the strengths of pre-trained language models with a dynamic retrieval mechanism, allowing it to access and synthesize real-time medical knowledge from a wide array of databases. By analyzing patient symptoms, medical histories, and contextual data, the assistant generates accurate, context-aware recommendations and insights. The project aims to streamline the diagnostic process, reduce the burden on healthcare professionals, and improve patient outcomes by providing evidence-based suggestions tailored to individual cases. Through continuous learning and integration of user feedback, the Health Diagnostic Assistant aspires to evolve into a reliable tool for both patients and clinicians, fostering informed decision-making in the healthcare landscape.

Hospital Length-of-Stay Prediction Using Machine Learning Algorithms—A Literature Review

Predicting hospital length of stay is critical for efficient hospital management, enabling proactive resource allocation, the optimization of bed availability, and optimal patient care. This paper explores the potential of machine learning algorithms to revolutionize hospital length-of-stay predictions, contributing to healthcare efficiency and patient care. The main objective is to identify the most effective machine learning algorithm for building a predictive model capable of predicting hospital length of stay. The bibliographic search of the existing literature on machine learning algorithms applied to hospital length of stay predictions highlighted the most relevant papers within this area of research. The papers were analyzed in terms of model types and metrics that contributed to the considerable impact on healthcare decision making. We also discuss the challenges and limitations of machine learning algorithms for predicting length of stay, and the importance of data quality and ethical considerations.

Challenges associated with access to recently developed hemophilia treatments in routine care: perspectives of healthcare professionals.

The treatment landscape for haemophilia continues to rapidly develop, and expectations for future treatment success are high. There is limited information on the challenges to accessing new and innovative therapies. The aim of this study was to explore challenges with accessing haemophilia treatment from the perspective of healthcare professionals (HCPs). A crosssectional study design was used. A pilot-tested, online survey was distributed to haemophilia treatment centres in Australia, Canada, France, Italy, New Zealand, Republic of Ireland, Turkey, the United States, and the United Kingdom. The questionnaire covered questions on product access, economic considerations, health technology assessment requirements, and patient organization involvement. The results were analyzed descriptively using SPSS. A total of 154 HCPs completed the questionnaire. There was heterogeneity across countries, regions, and centres regarding HCPs' knowledge of access to novel recently developed treatments. Notable limitations to access were reported such as differences in access based on age of patient and type of product, economic considerations, and the growing influence of HTA bodies. Many countries have a hemophilia patient organization that does not have a vote at the decision-making table. There is a need to empower HCPs to better understand national healthcare structures and decisions that lead to access limitations. Requirements from HTA bodies must be understood to optimally design clinical studies and value generation of treatment options. This may strengthen the haemophilia treatment centre's voice to collectively mandate for exchange with key involved individuals, such as the payers and politicians for the provision of optimal therapy.