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A Simple Model to Assess and Improve Adherence to Iron Chelation Therapy with Deferoxamine in Patients with Thalassemia
Author(s) -
PAKBAZ ZAHRA,
FISCHER ROLAND,
TREADWELL MARSHA,
YAMASHITA ROBERT,
FUNG ELLEN B.,
CALVELLI LISA,
QUIROLO KEITH,
FOOTE DRUCILLA,
HARMATZ PAUL,
VICHINSKY ELLIOTT P.
Publication year - 2005
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1345.065
Subject(s) - deferoxamine , medicine , thalassemia , dosing , chelation therapy , pediatrics
A bstract : Adherence to deferoxamine (DFO) is vital for the long‐term survival of patients with thalassemia; however, currently no measure exists to quantify adherence directly. In this study, 90 patients with thalassemia major underwent liver iron concentration (LIC) assessment by SQUID biosusceptometer, were asked to rate their adherence to DFO using a Numerical Likert Scale (NLS), and were educated about complications of iron overload. Of 38% ( n = 28 ) of patients who rated themselves as very compliant, 19 had elevated LIC related to inadequate dosing of DFO and nine reported nonadherence in the past. Adherence improved after counseling and LIC decreased by 25% (7‐60%) in eight previously noncompliant patients who returned for subsequent LIC over 15 months. In conclusion, the NLS seems to be a simple but reliable tool to assess patients' adherence to DFO. Education and frequent noninvasive LIC assessments can improve adherence and iron burden. Elevated LIC does not necessarily reflect concurrent noncompliance; however, it can be an indication of nonadherence in the past.