Evangeli Michael, Mughal Kulsoom, Porter John B
Department of Psychology, Royal Holloway, University of London, Egham, Surrey, UK.
Hemoglobin. 2010 Jun;34(3):305-21. doi: 10.3109/03630269.2010.485080.
Good adherence to iron chelation therapy in thalassemia is crucial. Although there is evidence that adherence is related to regimen factors, there has been less emphasis on the relationship between psychosocial (psychological, demographic and social) factors and adherence. We present a systematic review of psychosocial correlates of chelation adherence in thalassemia. Nine studies met the inclusion criteria. Information was extracted regarding the study characteristics and the relationship between psychosocial factors and chelation adherence. Methodological quality was rated. The studies took place in a range of countries, were mostly cross sectional in design, and examined adherence to deferoxamine (DFO) only. Sample sizes ranged from 15 to 1573. A variety of psychosocial variables were examined. Definitions of adherence varied between studies and non adherence rates were also variable (9 to 66%). Older age was consistently associated with lower levels of chelation adherence. There were few other consistent findings. The methodological quality of studies was variable. There is a need for more methodologically sophisticated and theoretically informed studies on psychosocial correlates of chelation adherence. We offer specific suggestions.
地中海贫血患者良好坚持铁螯合治疗至关重要。尽管有证据表明坚持治疗与治疗方案因素有关，但心理社会（心理、人口统计学和社会）因素与坚持治疗之间的关系较少受到关注。我们对地中海贫血患者螯合治疗依从性的心理社会相关因素进行了系统综述。九项研究符合纳入标准。提取了有关研究特征以及心理社会因素与螯合治疗依从性之间关系的信息。对方法学质量进行了评分。这些研究在多个国家开展，设计大多为横断面研究，且仅考察了去铁胺（DFO）的依从性。样本量从15至1573不等。研究了多种心理社会变量。不同研究对依从性的定义不同，不依从率也各不相同（9%至66%）。年龄较大始终与较低的螯合治疗依从性相关。几乎没有其他一致的研究结果。研究的方法学质量参差不齐。需要开展更多方法学上更精细且有理论依据的关于螯合治疗依从性心理社会相关因素的研究。我们提供了具体建议。
