Document Detail


Adherence to deferasirox in children and adolescents with sickle cell disease during 1-year of therapy.
MedLine Citation:
PMID:  19734806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Adherence to long-term treatment is challenging. Deferasirox (DFX) is a daily oral iron chelator approved in the United States for transfusional iron overload.
PROCEDURES: Twenty-one subjects with sickle cell disease (mean age 13.8+/-4.2 y) received DFX 20 to 30 mg/kg daily for 1-year while on chronic blood transfusions. Good adherence to DFX was defined as > or =80% intake of prescribed dose. Adherence was assessed by monthly pill counts and calendars, and questionnaires at 1, 3, 6, and 12 months follow-up.
RESULTS: Fifteen of 21 subjects (71%) were adherent to DFX according to self-reports, with 83% of the patients being adherent at 1 month, 89% at 3 months, 65% at 6 months, and 78% at 12 months. We were only able to document continuous good adherence in 43% of patients by pill counts because of poor bottle return. The discrepancy between pill counts and self-reports may be related to over-reporting, with the real adherence being lower. Parental involvement with DFX administration (P=0.03) and age < or =16 years (P=0.0055) correlated with adherence. We could not detect a significant correlation between serum ferritin declines and adherence.
CONCLUSION: Seventy-one percent of patients adhered to DFX according to questionnaire responses but only 43% did according to pill counts. Adherence was poorer in adolescents older than 16 years of age and in patients who had no parental supervision of medications.
Authors:
Ofelia Alvarez; Hector Rodriguez-Cortes; Natasha Robinson; Noeline Lewis; Claudia Diaz Pow Sang; Gabriela Lopez-Mitnik; Carole Paley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric hematology/oncology     Volume:  31     ISSN:  1536-3678     ISO Abbreviation:  J. Pediatr. Hematol. Oncol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2010-01-06     Completed Date:  2010-01-25     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  9505928     Medline TA:  J Pediatr Hematol Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  739-44     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Division of Pediatric Hematology-Oncology, University of Miami Miller School ofMedicine, Miami, FL 33136, USA. oalvarez2@-med.miami.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Anemia, Sickle Cell / complications,  drug therapy*
Benzoates / administration & dosage*
Blood Transfusion
Child
Female
Ferritins / blood
Humans
Iron Chelating Agents / therapeutic use
Iron Overload / drug therapy,  etiology
Male
Parents
Patient Compliance / statistics & numerical data*
Questionnaires
Triazoles / administration & dosage*
Chemical
Reg. No./Substance:
0/Benzoates; 0/Iron Chelating Agents; 0/Triazoles; 9007-73-2/Ferritins; V8G4MOF2V9/deferasirox

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