Preventing lives affected by hemophilia: A mixed methods study of the views of adults with hemophilia and their families toward genetic screening.

Felicity K Boardman, Rachel Hale, Raksha Gohel, Philip J Young
Author Information
  1. Felicity K Boardman: Warwick Medical School, University of Warwick, Coventry, UK. ORCID
  2. Rachel Hale: Warwick Medical School, University of Warwick, Coventry, UK.
  3. Raksha Gohel: School of Life Sciences, University of Warwick, Coventry, UK.
  4. Philip J Young: School of Life Sciences, University of Warwick, Coventry, UK.

Abstract

BACKGROUND: Genomic sequencing technologies have made the possibility of population screening for whole panels of genetic disorders more feasible than ever before. As one of the most common single gene disorders affecting the UK population, hemophilia is an attractive candidate to include on such screening panels. However, very little is known about views toward genetic screening amongst people with hemophilia or their family members, despite the potential for a wide range of impacts on them.
METHODS: Twenty-two in-depth qualitative interviews were undertaken to explore the views of adults with hemophilia and their family members, recruited through the Haemophilia Society UK. These interviews were used to develop a survey, the Haemophilia Screening Survey (UK), which was distributed in paper and online format through the support group, receiving 327 returns between January and June 2018.
RESULTS: Fifty-seven per cent of the sample supported preconception carrier screening of the population for hemophilia, and 59% supported prenatal carrier screening. Key reasons for support included a desire to reduce pregnancy terminations and increase awareness of hemophilia. Despite support for screening however, 90% of the sample disagreed with pregnancy terminations for hemophilia.
CONCLUSIONS: Families and adults living with hemophilia are more supportive of screening for information and preparation purposes than to prevent boys with hemophilia from being born. A distinction was made between preventing the disease and preventing the lives of people with it, with support shown for the use of screening to achieve the former, but not at the expense of the latter.

Keywords

References

  1. Eur J Hum Genet. 2008 Apr;16(4):435-44 [PMID: 18059419]
  2. Soc Sci Med. 2006 Jul;63(1):32-42 [PMID: 16431006]
  3. Pediatr Blood Cancer. 2017 Jan;64(1):121-127 [PMID: 27472376]
  4. Clin Genet. 1994 Jun;45(6):308-12 [PMID: 7923862]
  5. Prenat Diagn. 2001 Jan;21(1):1-9 [PMID: 11180232]
  6. Mol Genet Genomic Med. 2018 Nov;6(6):941-956 [PMID: 30196552]
  7. J Genet Couns. 2018 Jun 16;: [PMID: 29909595]
  8. Eur J Hum Genet. 2016 Apr;24(4):506-12 [PMID: 26220700]
  9. J Appl Res Intellect Disabil. 2017 Mar;30(2):395-406 [PMID: 27168113]
  10. Sociol Health Illn. 2011 Mar;33(3):420-33 [PMID: 21054442]
  11. Haemophilia. 2014 Jul;20(4):e287-95 [PMID: 24800872]
  12. Haemophilia. 2012 Jul;18(4):584-92 [PMID: 22250892]
  13. Genet Med. 2018 Apr;20(5):513-523 [PMID: 29261177]
  14. Haemophilia. 2000 Jan;6(1):33-40 [PMID: 10632739]
  15. Am J Med Genet. 1988 Oct;31(2):259-67 [PMID: 3232693]
  16. Haemophilia. 2002 Jan;8(1):51-5 [PMID: 11886465]
  17. J Formos Med Assoc. 2015 Aug;114(8):722-8 [PMID: 23932837]
  18. Patient Educ Couns. 2007 Nov;68(3):235-42 [PMID: 17904328]
  19. Haemophilia. 2007 Sep;13(5):633-41 [PMID: 17880455]
  20. Am J Hum Genet. 1998 Oct;63(4):1175-80 [PMID: 9758618]
  21. Haemophilia. 2008 May;14(3):584-92 [PMID: 18282148]
  22. Genet Test Mol Biomarkers. 2011 Mar;15(3):159-64 [PMID: 21204697]
  23. Am J Med Genet. 1990 Sep;37(1):147-54 [PMID: 2240033]
  24. J Med Genet. 2003 Jun;40(6):e80 [PMID: 12807979]
  25. J Health Psychol. 2002 Mar;7(2):169-81 [PMID: 22114236]
  26. Sociol Health Illn. 2009 Jan;31(1):81-97 [PMID: 19144088]
  27. Pediatr Hematol Oncol. 1994 Jul-Aug;11(4):387-97 [PMID: 7947011]
  28. Mol Genet Genomic Med. 2019 May;7(5):e618 [PMID: 30838796]
  29. Am J Prev Med. 2010 Apr;38(4 Suppl):S456-8 [PMID: 20331943]
  30. Am J Med Genet A. 2013 Jan;161A(1):48-58 [PMID: 23239566]
  31. Haemophilia. 2012 Jul;18(4):575-83 [PMID: 21951674]
  32. Soc Sci Med. 1993 Sep;37(5):639-48 [PMID: 8211278]
  33. Am J Med Genet A. 2017 Feb;173(2):421-434 [PMID: 27792846]
  34. Am J Med Genet. 2002 Feb 15;108(1):29-35 [PMID: 11857546]
  35. Am J Med Genet A. 2016 Mar;170(3):565-73 [PMID: 26889673]
  36. Haemophilia. 2014 Nov;20(6):854-8 [PMID: 25273847]
  37. J Community Genet. 2014 Jul;5(3):215-22 [PMID: 24366860]
  38. J Genet Couns. 2000 Apr;9(2):137-52 [PMID: 12530456]

Grants

  1. Investigator Award 203384/Z/16/Z/Wellcome Trust

MeSH Term

Adolescent
Adult
Aged
Attitude
Family
Female
Genetic Carrier Screening
Genetic Counseling
Hemophilia A
Humans
Male
Middle Aged
Patients
Surveys and Questionnaires
United Kingdom