Treatment disruption and psychological distress among hemophilia patients during the COVID-19 pandemic: the role of healthcare accessibility

The strict zero-COVID policies in China, lasting from early 2020 to late 2022, posed unique challenges to chronic disease management. While the pandemic’s mental health impact is well-documented, evidence regarding patients with hemophilia remains limited. This study aimed to assess the prevalence of psychological distress and its determinants among these patients following the relaxation of containment measures. We conducted a cross-sectional study among 208 patients with hemophilia aged ≥ 12 years at the Hemophilia Diagnosis and Treatment Center in Fujian Province. The survey was carried out from February 1 to February 7, 2023. The Kessler Psychological Distress Scale (K10) was used to assess psychological distress over the past four weeks. Chi-square tests, along with univariate and multivariate logistic regression analyses, were employed to identify factors associated with psychological distress, with a p value < 0.05 considered statistically significant. A total of 38.5% of patients exhibited varying degrees of psychological distress in the context of the COVID-19 pandemic, which was primarily associated with treatment disruption ( p < 0.001). Multivariate logistic regression analysis indicated that treatment disruption was significantly associated with psychological distress (OR = 3.308; 95% CI 1.748–6.262; p < 0.001). Compared with patients without treatment disruption, a significantly lower proportion of those with treatment disruption were able to perform self-injection (45.3% vs. 72.4%; p = 0.001) and a significantly higher number facing restricted access to medication (73.4% vs. 45.8%; p < 0.001). Treatment disruption is the primary factor associated with psychological distress among patients with hemophilia during the COVID-19 pandemic. Greater self-injection capability, fewer restrictions on medication access, and adequate drug supply were associated with lower levels of psychological distress in this population during public health emergencies.