Home therapy for hemophilia in Thailand.

The home therapy for hemophilia in Thailand was initiated in 1979. The therapeutic material first used was frozen cryoprecipitate or fresh frozen plasma and later fresh dry plasma (FDP). During 1979-1982, ten patients attended regular home therapy. All of them lived in the rural area which were far from the provincial hospitals. The age ranged from 7 to 15 years with a mean age of 10 years. The duration of follow up ranged from 7 months to 7 years with a mean duration of 3 years. The utilized blood products as FDP varied from 3 to 30 bottles per year with a mean of 16 bottles per year or 0.5-2.9 bottles per kilogram body weight per year which increased gradually as the patients grow up. A total of 252 episodes of bleeding was recorded; mostly hemarthrosis 70% and muscular bleeding 19%. There was no any further disability detected in 6 cases (60%). The significant advantages were the reduction in admission rate from 6-8 admission per year to 0-1 admission per year; economic savings; psychological independence of well being and having a normal life. The disadvantage were inadequate dosage of infused material, delayed consultation and transfer which were preventable. Home therapy for hemophilia by using FDP is recommended for any developing country. It is safe, practical, efficient enough to preserve normal joint status and prevent disability.