Badawy Sherif M, Thompson Alexis A, Liem Robert I
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA; Department of Pediatrics, Division of Hematology and Oncology, Zagazig University Faculty of Medicine, Zagazig, Egypt.
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital, Chicago, IL, USA.
Hematol Oncol Stem Cell Ther. 2018 Sep;11(3):142-148. doi: 10.1016/j.hemonc.2018.01.001. Epub 2018 Feb 2.
Hydroxyurea reduces complications and improves health-related quality of life (HRQOL) in sickle cell disease (SCD) patients, however adherence remains suboptimal. Understanding patients' views of hydroxyurea is critical to optimize adherence, particularly in adolescents and young adults (AYA). Study objectives were to assess beliefs about hydroxyurea using the Beliefs about Medicines Questionnaire (BMQ), and to examine the relationship of patients' beliefs to their hydroxyurea adherence and HRQOL.
Thirty-four AYA with SCD participated in a cross-sectional study January-December 2015. Study assessments included BMQ to examine beliefs about hydroxyurea; Visual Analogue Scale (VAS) to assess hydroxyurea adherence; and Patient Reported Outcomes Measurement Information System (PROMIS®) to evaluate HRQOL.
Participants (41% female, 91% Black) had median age of 13.5 (IQR 12-18) years. Participants' concerns about overuse of medications correlated with concerns about hydroxyurea (r = 0.36, p = 0.04) and overall harm of medications (r = 0.5, p = 0.003). Participants' age positively correlated with the necessity of hydroxyurea (r = 0.45, p = 0.007). Participants' concerns about hydroxyurea and overuse of medications positively correlated with anxiety (r = 0.41, p = 0.02; r = 0.44, p = 0.01) and depression (r = 0.37, p = 0.04; r = 0.54, p = 0.001), but inversely correlated with peer relationships (r = -0.45, p = 0.03; r = -0.44, p = 0.03), respectively, suggesting better HRQOL with concerns. Fifty percent of participants reported low hydroxyurea adherence (VAS < 80%), which was more seen in patients with higher concerns about hydroxyurea (p = 0.02).
Beliefs about hydroxyurea correlated with HRQOL scores and adherence levels. Addressing patients' concern about hydroxyurea and medications overall as well as routine assessment of adherence and beliefs could help to overcome adherence barriers.
羟基脲可减少镰状细胞病（SCD）患者的并发症并改善其健康相关生活质量（HRQOL），然而其依从性仍不理想。了解患者对羟基脲的看法对于优化依从性至关重要，尤其是在青少年和青年（AYA）中。研究目的是使用药物信念问卷（BMQ）评估对羟基脲的信念，并检查患者信念与其羟基脲依从性和HRQOL之间的关系。
2015年1月至12月，34名患有SCD的AYA参与了一项横断面研究。研究评估包括用于检查对羟基脲信念的BMQ；用于评估羟基脲依从性的视觉模拟量表（VAS）；以及用于评估HRQOL的患者报告结局测量信息系统（PROMIS®）。
参与者（41%为女性，91%为黑人）的中位年龄为13.5岁（四分位间距12 - 18岁）。参与者对药物过度使用的担忧与对羟基脲的担忧相关（r = 0.36，p = 0.04）以及与药物的总体危害相关（r = 0.5，p = 0.003）。参与者的年龄与羟基脲的必要性呈正相关（r = 0.45，p = 0.007）。参与者对羟基脲和药物过度使用的担忧与焦虑呈正相关（r = 0.41，p = 0.02；r = 0.44，p = 0.01）和与抑郁呈正相关（r = 0.37，p = 0.04；r = 0.54，p = 0.001），但分别与同伴关系呈负相关（r = -0.45，p = 0.03；r = -0.44，p = 0.03），这表明担忧较少时HRQOL更好。50%的参与者报告羟基脲依从性低（VAS < 80%），这在对羟基脲担忧较高的患者中更常见（p = 0.02）。
对羟基脲的信念与HRQOL评分和依从性水平相关。解决患者对羟基脲和总体药物的担忧以及对依从性和信念的常规评估可能有助于克服依从性障碍。
