Patient-reported premonitory signs and symptoms (Prodromes) may predict attacks of Hereditary Angioedema

3^rd Euro Nursing & Medicare Summit

July 27-29, 2015 Valencia, Spain

Iris Leibovich1.2, Hava Golander2, Raz Somech3 and Avner Reshef1

1Allergy, Immunology & Angioedema Center, Sheba Medical Center, Tel- Hashomer 2Department of Nursing, Sackler School of Medicine 3Safra Pediatric Hospital, Tel-Hashomer. All affiliated to the University of Tel Aviv, Israel

Scientific Tracks Abstracts: J Nurs Care

Abstract :

Background: Premonitory symptoms (prodromes) are reported by a large majority of patients with hereditary angioedema (HAE). They include subjective and objective signs and symptoms and may precede the attacks by many hours. Previous studies show that prodromes are more frequent than previously assumed and might be overlooked by caretakers and specialists. They might provide important clues for the understanding of patients' illness trajectory and may help in early detection and interventions that may improve the outcome of HAE attacks. This preliminary study was aimed at understanding the association between prodromes and attacks by comparing similar dimensions (i.e. formation, location, severity, duration, organ dysfunction etc.) Methods: We report the results of a preliminary study of 15 HAE patients (6 men, 9 women, mean age 26.6 years, range 9-47). A specific questionnaire was constructed and refined, based on previous instruments used by our group and others. Data was obtained on the disease course and its burden on daily life, patients' experience with prodromes and whether they can predict an incoming attack based on such symptoms. The questions included either categorical parameters (yes/no) or nominal (duration, incidence etc.). Results: Most patients could identify and locate the various dimensions of the prodromes and differentiate them from the attacks. Prodrome dimensions were correlated to the attack in most organ clusters. Internal consistency (alpha Cronbach) of the various components of the questionnaires was high. Conclusions: Prodromes are frequently reported by HAE patients and there is an association between them and attack severity, location and dysfunction.

Biography :

Iris Leibovich-Nassi Graduate of Beilinson Nursing School, Israel (1982) with rich professional career in Nephrology, Ophthalmology, Gynecology and Allergy/ Immunology. Currently a senior nurse and study coordinator at the Angioedema Center, Sheba Medical Center affiliated to Sackler School of Medicine, Tel Aviv University. Past chair woman of the Israeli Allergy and Immunology Nursing Association. Presently member of the steering committee of the International HAE Nursing Association. She has Master's Degree in nursing and working on her PhD thesis, focusing on the premonitory signs and symptoms of Hereditary Angioedema (HAE) attacks ("Prodromes"). She is consulting to HAE patients in self-management, family matters and quality of life issues.

Email: iris.leibovich@sheba.health.gov.il