Clinical Pharmacist‐Provided Services In Iron‐Overloaded Beta‐Thalassaemia Major Children: A New Insight Into Patient Care

Abstract

Iron-overloaded β-thalassaemia major (BTM) children have high risk of delayed sexual/physical maturation, liver/heart diseases and reduced life expectancy. The lifelong need to use iron chelators, their unpleasant administration, side effects and lack of awareness regarding iron overload risks all hamper BTM patient compliance to iron chelators. This study evaluated the impact of clinical pharmacist-provided services on the outcome of iron-overloaded BTM children. Forty-eight BTM children were randomly assigned to either control group, who received standard medical care, or intervention group, who received standard medical care plus clinical pharmacist-provided services. Services included detection of drug-related problems (DRPs) and their management, patient education regarding disease nature and iron chelators, as well as providing patient-tailored medication charts. After six months of study implementation, there was a highly significant difference between the control and intervention groups in serum ferritin (SF) (mean: 3871 versus 2362, μg/l, p = 0.0042), patient healthcare satisfaction (median: 24.47 versus 90.29, p < 0.0001) and quality of life (QoL) (median: 49.84 versus 63.51, p = 0.0049). The intervention group showed a decline from baseline to the end of study in DRPs (64-4), the number of non-compliant patients (24-3) and mean SF levels (3949-2362 μg/l, p < 0.0001). Clinical pharmacist-provided services can positively impact the outcome of BTM children.

Interventions for improving adherence to iron chelation therapy in people with sickle cell disease or thalassaemia

“…Ten were multicentre trials (Calvaruso 2015; Elalfy 2015; Galanello 2006; Maggio 2009; Olivieri 1997; Pennell 2006; Pennell 2014; Taher 2017; Tanner 2007; Vichinsky 2007) and ranged from two centres in one country (Calvaruso 2015; Elalfy 2015; Olivieri 1997) to 44 centres in multiple countries (Vichinsky 2007). Six were single-centre trials (Aydinok 2007; Bahnasawy 2017; Badawy 2010; El Beshlawy 2008; Hassan 2016, Mourad 2003).…”

“…Follow-up ranged from six months in two trials (Bahnasawy 2017; Taher 2017) to five years in two trials (Calvaruso 2015; Maggio 2009). The remainder of the trials were of 12 months duration, except in the Badawy trial, which did not report follow-up time (Badawy 2010); and the Olivieri trial, which had 24 months follow-up (Olivieri 1997).…”

“…Trials were published between 1997 and 2017. Five were conducted in Egypt (Badawy 2010; Bahnasawy 2017; Elalfy 2015; El Beshlawy 2008, Hassan 2016); five in Italy (Calvaruso 2015; Galanello 2006; Maggio 2009; Pennell 2006; Tanner 2007); and three were international multicentre trials conducted in several countries (Pennell 2014; Taher 2017; Vichinsky 2007). One trial was conducted in each of the following countries: Turkey (Aydinok 2007); Lebanon (Mourad 2003); and Canada (Olivieri 1997).…”

“…Fourteen trials included only participants with β -thalassaemia major (Aydinok 2007; Badawy 2010; Bahnasawy 2017; Elalfy 2015; El Beshlawy 2008; Galanello 2006; Hassan 2016; Maggio 2009; Mourad 2003; Olivieri 1997; Pennell 2006; Pennell 2014; Taher 2017; Tanner 2007). One trial included only participants with SCD (Vichinsky 2007); and one trial included only participants with thalassaemia intermedia (Calvaruso 2015).…”

Identification of the area of service provided by clinical pharmacist in the pediatric patient care

“…poprawę parametrów biochemicznych (np. stężenia fosforanów, wapnia, ferrytyny, parathormonu) i jakości życia w porównaniu z grupą kontrolną [19,20]. Również u dzieci leczonych warfaryną lepszą kontrolę INR obserwowano w grupie pacjentów, których farmakoterapia nadzorowana była przez farmaceutę klinicznego [21].…”