{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:07:53Z","timestamp":1789837673293,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adherence to prophylactic replacement therapy is critical to prevent bleeding and joint damage in haemophilia. Although Brazil provides universal and free access to clotting factor concentrates (CFC) through the public health system, real\u2010world adherence remains insufficiently explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess adherence to prophylaxis and its association with bleeding outcomes in people with haemophilia A and B treated at two Haemophilia Treatment Centres (HTCs) in southeastern Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In retrospective observational study, 224 people with haemophilia receiving \u226512 months of FVIII or FIX prophylaxis in 2024 were included. Adherence was evaluated using pharmacy dispensing records by comparing expected annual prescribed CFC consumption with actual dispensed units. Patients were classified as optimal (&lt;15% non\u2010dispensed), suboptimal (15%\u201325%), or non\u2010adherent (&gt;25%). Annualized bleeding rate (ABR) and annualized joint bleeding rate (AJBR) were analyzed according to adherence status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Although the median factor dispensing rate was 73% (IQR: 47\u201396), this value falls below the 75% threshold, indicating a high overall prevalence of non\u2010adherence. When patients were stratified into optimal, suboptimal, and non\u2010adherent groups, 52% were classified as non\u2010adherent. Non\u2010adherence was more frequent in one centre (60.3%\u00a0vs. 43.7%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.027) and among individuals aged 20\u201339 years (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003). Despite high objective non\u2010adherence, median ABR and AJBR were zero across groups, although individual variability persisted, including bleeding events among adherent patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Even within a universal\u2010access health system, substantial gaps between prescribed and executed prophylaxis persist. Dispensing\u2010based adherence assessment reveals hidden non\u2010adherence and may support targeted multidisciplinary strategies to optimize long\u2010term outcomes in haemophilia care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70407","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:52:10Z","timestamp":1789836730000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gaps Between Prescription and Practice: Pharmacy\u2010Based Measurement of Prophylaxis Adherence in Haemophilia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1190-7236","authenticated-orcid":false,"given":"Debora M. C.","family":"Rocha\u2010Santiago","sequence":"first","affiliation":[{"name":"Federal University of Esp\u00edrito Santo (UFES)  Vit\u00f3ria Brazil"},{"name":"Hemocentro Do Esp\u00edrito Santo (HEMOES)  Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1008-4458","authenticated-orcid":false,"given":"J\u00e9ssica O.","family":"Frade\u2010Guanaes","sequence":"additional","affiliation":[{"name":"Hemocentro UNICAMP University of Campinas  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0350-8171","authenticated-orcid":false,"given":"Gabriela G.","family":"Yamaguti\u2010Hayakawa","sequence":"additional","affiliation":[{"name":"Hemocentro UNICAMP University of Campinas  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5938-0675","authenticated-orcid":false,"given":"Margareth C.","family":"Ozelo","sequence":"additional","affiliation":[{"name":"Hemocentro UNICAMP University of Campinas  Campinas S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1079-7140","authenticated-orcid":false,"given":"Alessandra N. L.","family":"Prezotti","sequence":"additional","affiliation":[{"name":"Hemocentro Do Esp\u00edrito Santo (HEMOES)  Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5618-1846","authenticated-orcid":false,"given":"Genival A.","family":"dos Santos Junior","sequence":"additional","affiliation":[{"name":"Federal University of Esp\u00edrito Santo (UFES)  Vit\u00f3ria Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.14046"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02139-1"},{"key":"e_1_2_12_4_1","unstructured":"World Federation of Hemophilia.Annual Global Survey 2024. Montreal; 2024."},{"key":"e_1_2_12_5_1","unstructured":"Minist\u00e9rio da Sa\u00fade. Dados de Coagulopatias 2024. 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