Jose Jimmy, Elsadek Refaat Abdullah, Jimmy Beena, George Prasad
School of Pharmacy, University of Nizwa, Nizwa, Oman.
Department of General Medicine, Nizwa Hospital, Nizwa, Oman.
Oman Med J. 2019 Jul;34(4):327-335. doi: 10.5001/omj.2019.64.
Many barriers contribute to the underutilization of hydroxyurea (HU) in the treatment of sickle cell disease (SCD), and adherence to its use is often reported to be suboptimal. It is important to have information on the safety of HU in patients with SCD. Our study assessed the pattern of use, patients' adherence to medication, discontinuation of use, and safety of HU in patients with SCD.
This cross-sectional study was conducted in the department of medicine of a referral hospital in Oman over five months and included a review of patient files and patient interview. Approval was obtained from the Regional Research and Ethics Committee of the A'Dakhiliyah Governorate and the hospital administration. The parameters were compared between groups using the chi-square test.
Of 298 patients studied, 128 (43.0%) had used HU at some points. The difference in the prevalence of HU use was statistically significant based only on age ( 0.014), with younger patients more likely to be currently using HU or used HU in the past. The majority of patients were adherent (82.5%) based on self-reported adherence. The prevalence of discontinuation (temporary or permanent) of HU use was high (57.0%), and suspected adverse drug reaction (ADR) was the most common reason. Among those who had never used HU, 33.7% of patients had an indication for the initiation of HU. A quarter of patients who used HU developed a suspected ADR, with blood abnormalities being the commonest. The duration of HU use influenced ADR prevalence ( 0.015).
Among the current users of HU, the majority of the patients were adherent based on self-reported medication adherence. The prevalence of discontinuation of HU use and instances of non-initiation of HU among those indicated were high. A larger study, ideally of a prospective nature, in various governorates of Oman, would provide a wider picture at the national level.
多种障碍导致羟基脲（HU）在镰状细胞病（SCD）治疗中的使用不足，且据报道其用药依从性往往不理想。了解HU在SCD患者中的安全性很重要。我们的研究评估了SCD患者中HU的使用模式、患者的用药依从性、停药情况及安全性。
这项横断面研究在阿曼一家转诊医院的内科进行，为期五个月，包括查阅患者档案和对患者进行访谈。获得了阿代赫利耶省区域研究与伦理委员会及医院管理部门的批准。使用卡方检验对组间参数进行比较。
在研究的298名患者中，128名（43.0%）在某些时候使用过HU。仅基于年龄，HU使用 prevalence 的差异具有统计学意义（P = 0.014），年轻患者更有可能目前正在使用HU或过去使用过HU。根据自我报告的依从性，大多数患者依从（82.5%）。HU使用的停药（暂时或永久）患病率很高（57.0%），疑似药物不良反应（ADR）是最常见的原因。在从未使用过HU的患者中，33.7%的患者有开始使用HU的指征。使用HU的患者中有四分之一出现疑似ADR，血液异常最为常见。HU使用时间影响ADR患病率（P = 0.015）。
在当前使用HU的患者中，根据自我报告的用药依从性，大多数患者依从。HU使用的停药患病率以及在有指征者中未开始使用HU的情况很高。在阿曼的各个省份进行一项更大规模的研究，理想情况下是前瞻性研究，将在国家层面提供更全面的情况。
