Adherence to Iron Chelation Therapy and Its Determinants

  • Sukhmani Sidhu Bachelor of Medicine and Bachelor of Surgery Student, Dayanand Medical College, Ludhiana, Punjab, India
  • Shruti Kakkar Mail Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India
  • Priyanka Dewan Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India
  • Namita Bansal Research & Development Unit, Dayanand Medical College, Ludhiana, Punjab, India
  • Praveen C. Sobti Guru Teg Bahadur Sahib Charitable Hospital, Ludhiana, Punjab, India
Keywords:
Adherence; Iron chelation therapy; Iron overload; Transfusion dependent thalassemia; Deferiprone; Deferasirox; Desferrioxamine

Abstract

Background: 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.

Materials and Methods: 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.  

Results:  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.

Conclusion: Nearly 11% of patients with TDT were non-adherent to ICT. Non-adherence results in higher iron overload. 

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Published
2021-01-13
How to Cite
1.
Sidhu S, Kakkar S, Dewan P, Bansal N, Sobti P. Adherence to Iron Chelation Therapy and Its Determinants. Int J Hematol Oncol Stem Cell Res. 15(1):27-34.
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