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

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows: To identify and assess the effectiveness of interventions to improve adherence to iron chelation therapy compared to standard care in people with SCD or thalassaemia including: identifying and assessing the effectiveness of different types of interventions (psychological and psychosocial, educational, medication interventions, or multi-component interventions);identifying and assessing the effectiveness of interventions specific to different age groups (children, adolescents, adults).

Optimising management of deferasirox therapy for patients with transfusion‐dependent thalassaemia and lower‐risk myelodysplastic syndromes

“…37 Serum ferritin levels, LIC, and signs of iron overload may also be used to assess adherence in patients with transfusion-dependent thalassaemia or MDS. 37 Self-reporting may overestimate adherence, with self-reported iron chelator adherence in adolescents with thalassaemia seemingly higher than adherence indicated by serum ferritin levels. 38 Indeed, adolescents pose particular challenges in terms of both evaluating adherence (with the reliability of information improved when it comes from multiple sources such as the adolescent, their parents, and healthcare providers) and maintaining adherence.…”

Subcutaneous hydration and medications infusions (effectiveness, safety, acceptability): A systematic review of systematic reviews

“…Table 1 details the 26 systematic reviews of subcutaneous infusion of medications and/or fluids with 14 focused on medications only, 9 on fluids and 3 on both types of therapies. The publication dates of reviews ranged between 1997 [23] and 2019 [24,25]. Most reviews focused on adult populations generally or specifically, for example, pregnant women and adults with amyotrophic lateral sclerosis (ALS).…”

“…Most reviews focused on adult populations generally or specifically, for example, pregnant women and adults with amyotrophic lateral sclerosis (ALS). Two reviews, however, are specifically paediatric [26,27]; eight all ages [15,16,25,28,[29][30][31][32]; two focused on older adults and paediatrics [33,34] and one where age was not reported [24].…”

Deferasirox: Over a Decade of Experience in Thalassemia

“…A recent Cochrane review exploring the interventions needed for improving adherence to ICT in patients with thalassemia or sickle cell disease concluded that real-life data is required to assess specific adherence strategies and thus make recommendations in this setting. 81 …”