Sidhu Sukhmani, Kakkar Shruti, Dewan Priyanka, Bansal Namita, Sobti Praveen C
Bachelor of Medicine and Bachelor of Surgery Student, Dayanand Medical College, Ludhiana, Punjab, India.
Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India.
Int J Hematol Oncol Stem Cell Res. 2021 Jan 1;15(1):27-34. doi: 10.18502/ijhoscr.v15i1.5247.
: Thalassemia is a chronic disease requiring lifelong treatment. The adherence to regular iron chelation therapy is important to ensure complication-free survival and good quality of life. The study aim to assess the adherence to iron chelation therapy (ICT) in patients with transfusion-dependent thalassemia (TDT), evaluate various causes of non-adherence and study the impact of non-adherence on the prevalence of complications secondary to iron overload. Patients with TDT on ICT for > 6 months were enrolled in the study. Hospital records were reviewed for demographic details, iron overload status, treatment details, and the prevalence of complications. A study questionnaire was used to collect information on adherence to ICT, knowledge of patients, and the possible reasons for non-adherence. A total of 215 patients with a mean age of 15.07+7.68 years and an M: F ratio of 2.2:1 were included in the study. Non-adherence to ICT was found in 10.7% of patients. Serum ferritin levels were significantly higher in the non-adherent group (3129.8+1573.2 µg/l) than the adherent population (2013.1+1277.1 µg/l). Cardiac as well as severe liver iron overload was higher in the non-adherent patients. No correlation was found between disease knowledge and adherence to ICT. Difficulties in drug administration and many medicines to be taken daily were statistically significant reasons for non-adherence. There was no difference in the co-morbidities arising due to the iron overload in the two groups. Nearly 11% of patients with TDT were non-adherent to ICT. Non-adherence results in higher iron overload.
地中海贫血是一种需要终身治疗的慢性疾病。坚持定期进行铁螯合治疗对于确保无并发症生存和良好生活质量至关重要。本研究旨在评估输血依赖型地中海贫血（TDT）患者对铁螯合治疗（ICT）的依从性，评估不依从的各种原因，并研究不依从对铁过载继发并发症患病率的影响。接受ICT治疗超过6个月的TDT患者被纳入本研究。查阅医院记录以获取人口统计学细节、铁过载状况、治疗细节以及并发症患病率。使用一份研究问卷收集关于ICT依从性、患者知识以及不依从的可能原因的信息。
本研究共纳入215例患者，平均年龄为15.07±7.68岁，男女比例为2.2∶1。发现10.7%的患者不依从ICT。不依从组的血清铁蛋白水平（3129.8±1573.2μg/L）显著高于依从组（2013.1±1277.1μg/L）。不依从患者的心脏以及严重肝脏铁过载情况更高。未发现疾病知识与ICT依从性之间存在相关性。药物给药困难以及每日需服用多种药物是不依从的统计学显著原因。两组因铁过载引起的合并症无差异。
近11%的TDT患者不依从ICT。不依从会导致更高的铁过载。
