Assessment of Adherence to Iron Chelation Therapy Among Thalassemia Patients in Palestine.

IF 3.7 Q3 HEMATOLOGY

Anemia Pub Date : 2025-11-29 eCollection Date: 2025-01-01 DOI:10.1155/anem/6649477

Hamzeh Al Zabadi, Zein Ieran, Ibrahim Taha

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Abstract

Background: Beta-thalassemia major (β-TM) is a severe hereditary blood disorder, common in Palestine due to high consanguinity rates. Lifelong iron chelation therapy (ICT) is vital for managing iron overload from regular transfusions, but adherence remains a major challenge.

Objective: This study investigates factors influencing ICT adherence among β-TM patients in Palestine, focusing on sociodemographic, clinical, psychological, and healthcare-related aspects.

Methods: A cross-sectional study was conducted at the National Thalassemia Center, Nablus, from July 2024 to the end of October 2024, including 120 β-TM patients aged 3-33. Data were collected through structured interviews using a validated questionnaire covering demographics, disease knowledge, adherence, and satisfaction with healthcare. Adherence was based on missed doses and ferritin levels, analyzed using SPSS V21.0.

Results: 62.5% of patients were adherent, with ferritin levels ≤ 2500, while nonadherent patients had levels ≥ 2501 (p < 0.001). Although 98.7% of adherent and 100% of nonadherent patients had good disease knowledge, it did not predict adherence. Barriers included psychological distress (21.7%), medication side effects (16.7%), and inconsistent medication supply. Satisfaction with healthcare staff (p < 0.001) and socioeconomic status, particularly income (p = 0.014), significantly affected adherence.

Conclusion: Adherence is influenced more by psychological, economic, and healthcare service factors than knowledge. A multidisciplinary approach-providing psychological support, stable medication access, and stronger patient-provider relationships-is essential to improve adherence and outcomes for β-TM patients in Palestine.

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巴勒斯坦地中海贫血患者铁螯合治疗依从性评估。

背景：β-地中海贫血（β-TM）是一种严重的遗传性血液疾病，常见于巴勒斯坦，因其高血亲率。终身铁螯合治疗（ICT）对于控制定期输血造成的铁超载至关重要，但坚持治疗仍然是一个主要挑战。目的：研究巴勒斯坦β-TM患者ICT依从性的影响因素，包括社会人口学、临床、心理和卫生保健相关方面。方法：于2024年7月至2024年10月底在纳布卢斯国家地中海贫血中心进行横断面研究，包括120例3-33岁的β-TM患者。数据通过结构化访谈收集，使用有效的问卷调查，涵盖人口统计、疾病知识、依从性和对医疗保健的满意度。依从性基于遗漏剂量和铁蛋白水平，使用SPSS V21.0进行分析。结果：62.5%的患者粘附，铁蛋白水平≤2500，非粘附患者铁蛋白水平≥2501 （p < 0.001）。虽然98.7%的依从性患者和100%的非依从性患者有良好的疾病知识，但这并不能预测依从性。障碍包括心理困扰（21.7%）、药物副作用（16.7%）和药物供应不一致。对医护人员的满意度（p < 0.001）和社会经济地位，特别是收入（p = 0.014）显著影响依从性。结论：心理、经济和卫生保健服务因素对依从性的影响大于知识因素。多学科方法——提供心理支持、稳定的药物获取和更强的医患关系——对于改善巴勒斯坦β-TM患者的依从性和预后至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anemia HEMATOLOGY-

CiteScore

4.80

自引率

3.40%

发文量

审稿时长

18 weeks

期刊介绍： Anemia is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all types of anemia. Articles focusing on patient care, health systems, epidemiology, and animal models will be considered, among other relevant topics. Affecting roughly one third of the world’s population, anemia is a major public health concern. The journal aims to facilitate the exchange of research addressing global health and mortality relating to anemia and associated diseases.