Centre of Excellence for Sickle Cell Research and Training (CESRTA), University of Abuja, Abuja, Nigeria.
Department of Haematology, College of Health Sciences, University of Abuja, Abuja, Nigeria.
PLoS One. 2022 Nov 10;17(11):e0276639. doi: 10.1371/journal.pone.0276639. eCollection 2022.
Hydroxyurea (HU) is an evidence-based therapy that is currently the most effective drug for sickle cell disease (SCD). HU is widely used in high-income countries with consequent reduction of morbidity and mortality. In Nigeria, HU is prescribed by physicians while nurses are mainly involved in counseling the patients to ensure adherence. The extent of utilization and the determinant factors have not been sufficiently evaluated in Nigeria.
To assess the frequency of use of HU and factors affecting utilization among healthcare providers, patients, and caregivers for SCD.
A questionnaire was administered online and in- person to assess the frequency of HU use and the factors that promote and limit its use. The data were analyzed by descriptive statistics using IBM SPSS software version 23 and the result was presented in frequency tables and percentages.
A total of 137 physicians, 137 nurses, and 237 patients/caregivers responded to the survey. The rate of prescription of HU by doctors in the past 6 months was 64 (46.7%), 43 (31.4%) nurses provided counseling and 36 (15.6%) patients were on HU. Among doctors, adequate knowledge (91.3%), clinical benefits and safety (94.8%), and inclusion of HU in management guidelines (86.9%) were motivators for prescribing it while inadequate knowledge (60.9%) and unawareness of treatment guidelines (68.6%) constituted barriers. Among nurses, reduction of crisis (91.6%) and safety (64.8%) were the major motivators while barriers were high cost (79.1%) and intensive monitoring (63.1%) of HU treatment. Among the patients, the major motivator was the reduction of crises (80.3%) while poor knowledge (93.2%), high cost of the drug (92.2%) while monitoring (91.2%), non-availability (87.7%) and side effects (83.9%) were the major barriers for the utilization of HU.
HU prescription and utilization are still poor among healthcare providers and patients. Inadequate knowledge, non-availability and high cost of HU as well as unawareness of treatment guidelines constitute major barriers to prescription and utilization.
羟基脲 (HU) 是一种循证治疗方法，目前是治疗镰状细胞病 (SCD) 最有效的药物。HU 在高收入国家得到广泛应用，从而降低了发病率和死亡率。在尼日利亚，医生开 HU 处方，而护士主要参与咨询患者以确保其遵医嘱。HU 的使用程度及其决定因素尚未在尼日利亚得到充分评估。
评估医护人员、患者和照顾者开 HU 处方的频率以及影响 HU 使用的因素，以评估 SCD 患者使用 HU 的情况。
通过在线和现场方式向 137 名医生、137 名护士和 237 名患者/照顾者发放问卷，评估 HU 使用频率以及促进和限制 HU 使用的因素。使用 IBM SPSS 软件版本 23 进行描述性统计分析，结果以频数表和百分比表示。
共有 137 名医生、137 名护士和 237 名患者/照顾者对调查做出回应。过去 6 个月，医生开具 HU 处方的比例为 64 例（46.7%），43 名护士提供咨询，36 名患者服用 HU。医生开 HU 处方的主要动机包括具备充分的知识（91.3%）、临床获益和安全性（94.8%）以及 HU 纳入管理指南（86.9%），而缺乏知识（60.9%）和不了解治疗指南（68.6%）则构成障碍。护士开 HU 处方的主要动机包括减少危机（91.6%）和安全性（64.8%），而障碍则是 HU 治疗费用高（79.1%）和需要加强监测（63.1%）。患者开 HU 处方的主要动机是减少危机（80.3%），而主要障碍包括缺乏知识（93.2%）、药物费用高（92.2%）和监测（91.2%）、药物不可获得（87.7%）和副作用（83.9%）。
医护人员和患者 HU 处方和使用率仍然较低。缺乏知识、药物不可获得、HU 费用高以及不了解治疗指南是处方和使用率低的主要障碍。
