Predictors of Non-adherence to iron chelation therapy in pediatric thalassemia patients

Abstract

Objective: This study was conducted to identify predictors of non-adherence to iron chelation therapy among children suffering from β-thalassemia major across different treatment regimens.Materials and Methods: It was a cross-sectional study carried out from 1st January 2019 to 30th June 2019. The study was conducted at the Pakistan Institute of Thalassemia, Islamabad. Children between the ages of 2 -16 years suffering from β-Thalassemia major and taking iron chelation therapy were included in the study. Chelation adherence for this analysis was defined as the percent of doses taken in the last 12 weeks out of those prescribed. Guardians of patients were interviewed using a questionnaire and medical records were checked. Data were analysed using SPSS 20.0. Multivariate analysis was conducted to identify the predictors for non-adherence to chelation therapy. The significant value was set at ≤ 0.05.Results: Mean age of the patients in our study was 8.90± 3.74 years. There were 33 males and 64 females. Most of the patients n=87 (89.7%) were taking oral iron chelation therapy. The mean score for chelation adherence was 67.12%. Among the multiple demographic, medical-related, and patient-related factors analysed, travel time from the patient’s residence to the treatment centre and the number of transfusions per year were found to be significant predictors (p-value ≤0.05) of non-adherence to iron chelation therapy. Conclusion: Overall, the study provides strong evidence that healthcare-related factors play a major role in patients’ adherence to treatment. A systemic approach should be taken to ensure patient adherence during the management of paediatric thalassemic patients.