Healthcare professionals (HCPs) agreed that a team approach in a nonhierarchical form, including regular meetings with every professional and ensuring that all multidisciplinary team (MDT) members know all patients, is necessary for comprehensive hemophilia care, as published in Clinical and Applied Thrombosis/Hemostasis.

The authors assessed the qualitative aspects of an MDT approach in Canada and the United Kingdom for patients with hemophilia, and more specifically, hemophilic arthropathy.

Typical MDTs for patients with hemophilia have a hematologist, nurse, and physiotherapist; occasionally, there is also an orthopedic surgeon. Pediatric MDTs also include a psychologist or social worker, and adult MDTs sometimes have one as well.

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The authors used a 1-hour structured interview to break down the different care methods by 24 HCPs from MDTs treating hemophilic arthropathy. Most participating HCPs were hematologists (33%), nurses (21%), and physiotherapists (21%), and 33% of the HCPs had between 5 and 10 years of experience in their specialty.

Importantly, HCPs stressed the importance of MDTs, which involve regular team meetings with all HCPs in patient care. Some HCPs had crucial roles, ie, nurses and physiotherapists because their roles involved several aspects of patient care.

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HCPs also found MDTs valuable for transitioning. “Respondents agreed that MDTs are crucial for successful transitioning, which can be facilitated by close collaboration between pediatric and adult MDTs, even when they are not co-located,” the authors noted.

Physiotherapists or hematologists did orthopedic referrals, with the nurse, physiotherapist, and hematologist working together in patient preparation for surgery and follow-up. On the other hand, physiotherapists were critical in supplying nonpharmacological pain relief, one of the main aspects affecting the patient quality of life. 

The study suggests that despite significant differences between the Canadian and UK health systems, the MDT practice for hemophilia patients was adequate in both countries. Likewise, the authors stressed the importance of each of the HCPs in the MDTs when taking care of patients with hemophilia.

“In light of the critical and indispensable roles of nurses, physiotherapists, and social workers/psychologists in the daily functioning of efficient MDTs, this study suggests ways these professionals can be most effective,” the authors concluded. “Importantly, this study also helps all HCPs involved in hemophilia management to better understand the critical role and value of the MDT approach in providing optimal patient care.”


St-Louis J, Chowdary P, Dolan G, et al. Multidisciplinary team care of patients with hemophilic arthropathy: a qualitative assessment of contemporary practice in the UK and Canada: Canada/UK: MDT practices for hemophiliaClin Appl Thromb Hemost. Published online January 21, 2022. doi:10.1177/10760296211070002