Pharmacy Department, Hospital Wanita Dan Kanak-Kanak Sabah, Sabah, Malaysia.
Pharmacy Department, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.
Hemoglobin. 2023 Nov;47(6):237-244. doi: 10.1080/03630269.2023.2295291. Epub 2024 Jan 22.
Adherence to iron chelation therapy (ICT) remains an issue among thalassemia patients. This study aimed to determine the prevalence of non-adherence to ICT among children with beta thalassemia major in Malaysia and the factors associated with it.
This was a cross-sectional study conducted between November 2019 and November 2021 at seven tertiary hospitals in Malaysia. Participants registered with Malaysian Thalassemia Registry were recruited by convenience sampling. Adherence was measured via pill count and self-reported adherence. Knowledge about thalassemia and ICT was measured using a questionnaire from by Ministry of Health of Malaysia. A decision tree was used to identify predictors of non-adherence.
A total of 135 patients were recruited. The prevalence of non-adherence to ICT in those who took subcutaneous ± oral medications was 47.5% (95% CI: 31.5%, 63.9%) and the prevalence of non-adherence to ICT in those who took oral medications only was 21.1% (95% CI: 13.4%, 30.6%). The median knowledge score was 67.5% (IQR 15%). A decision tree has identified two factors associated with non-adherence. They were ICT's route of administration and knowledge score. Out of 100 patients who were on oral medications only, 79 were expected to adhere. Out of 100 patients who were on subcutaneous ± oral medications and scored less than 56.25% in knowledge questionnaire, 86 were expected to non-adhere. Based on the logistic regression, the odds of non-adherence in patients who took oral medications only was 71% lower than the odds of non-adherence in patients who took subcutaneous ± oral medications (OR = 0.29; 95% CI = 0.13, 0.65; = .002).
The prevalence of non-adherence to ICT among children with beta thalassemia major in Malaysia was 20/95 (21.1%) in those who took oral medications only and the prevalence of non-adherence was 19/40 (47.5%) in those who took subcutaneous ± oral medications. The factors associated with non-adherence were ICT's route of administration and knowledge score.
铁螯合疗法（ICT）的依从性仍然是地中海贫血患者面临的一个问题。本研究旨在确定马来西亚重型β地中海贫血儿童 ICT 不依从的发生率及其相关因素。
这是一项 2019 年 11 月至 2021 年 11 月在马来西亚 7 家三级医院进行的横断面研究。通过马来西亚地中海贫血登记处注册的参与者通过方便抽样招募。通过药丸计数和自我报告的依从性来衡量依从性。对来自马来西亚卫生部的问卷进行的关于地中海贫血和 ICT 知识的测量。决策树用于确定不依从的预测因素。
共招募了 135 名患者。接受皮下+口服药物治疗的患者 ICT 不依从率为 47.5%（95%CI：31.5%，63.9%），仅接受口服药物治疗的患者 ICT 不依从率为 21.1%（95%CI：13.4%，30.6%）。知识得分中位数为 67.5%（IQR 15%）。决策树确定了与不依从相关的两个因素。它们是 ICT 的给药途径和知识得分。在仅接受口服药物治疗的 100 名患者中，预计有 79 名患者会坚持治疗。在接受皮下+口服药物治疗且知识问卷得分低于 56.25%的 100 名患者中，预计有 86 名患者会不依从。基于逻辑回归，仅接受口服药物治疗的患者不依从的可能性比接受皮下+口服药物治疗的患者低 71%（OR=0.29；95%CI=0.13，0.65； = .002）。
马来西亚重型β地中海贫血儿童 ICT 不依从的发生率在仅接受口服药物治疗的患者中为 20/95（21.1%），在接受皮下+口服药物治疗的患者中为 19/40（47.5%）。与不依从相关的因素是 ICT 的给药途径和知识得分。
Zotero 插件