羟基脲治疗镰状细胞病:在低收入和中等收入的设置护理提供者的知识和处方模式。

Akinyemi O D Ofakunrin, Edache Sylvanus Okpe, Rasaq Olaosebikan, Onyeka Mary Ukpoju-Ebonyi, Tolulope Olumide Afolaranmi, Dangkat Bitrus Kilson, Stephen Oguche
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引用次数: 0

摘要

背景:羟基脲对镰状细胞病(SCD)患者是一种安全、有效、耐受性良好的疾病改善疗法,可降低发病率、死亡率,提高生活质量。然而,由于知识不足和SCD护理提供者使用的差异,其利用不足可能会限制其效益。本研究评估了尼日利亚乔斯SCD护理提供者中羟基脲的知识和处方模式。方法:对132名管理SCD的医生进行横断面调查,收集社会人口统计学、羟基脲知识和处方模式的数据。知识评估使用17个问题(最高得分:17)。分数在12分以上(第50百分位)为“好”,分数在12分以下为“差”。处方模式根据美国国立卫生研究院(2014年)和英国血液病学会(2018年)的指南进行了评估。数据分析采用描述性和推断性统计。结果:132名医生中67名(50.8%)对羟基脲的临床益处和安全性认识不足。只有35人(26.5%)知道现有的治疗指南,32人(24.2%)曾开过羟基脲处方。在开处方者中,9名(28.1%)使用不适当的标准开始治疗,6名(18.8%)处方剂量低于推荐剂量。每日最大处方剂量中位数为750mg,而5名(15.6%)医生不超过200mg,与患者体重无关。25名(78.1%)开处方者未遵循治疗指南。结论:本研究揭示了SCD护理提供者对羟基脲的知识不足和不一致的处方做法的高患病率。有针对性的培训是必不可少的,以提高羟基脲的利用,并确保遵守标准化的治疗指南,最终改善患者的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hydroxyurea therapy in sickle cell disease: knowledge and prescription patterns among care providers in a low-and middle-income setting.

Background: Hydroxyurea is a safe, effective, and well-tolerated disease-modifying therapy for patients with sickle cell disease (SCD), leading to reduced morbidity, mortality, and an improved quality of life. However, its underutilization, driven by inadequate knowledge and variability in use among SCD care providers, may limit its benefits. This study assessed the knowledge and prescription patterns of hydroxyurea among SCD care providers in Jos, Nigeria.

Methodology: A cross-sectional survey of 132 physicians managing SCD was conducted to collect data on socio-demographics, hydroxyurea knowledge, and prescription patterns using a proforma. Knowledge was assessed using 17 questions (maximum score: 17). Scores above 12 (50th percentile) were classified as "good," while scores of 12 or below were categorized as "poor." Prescription patterns were evaluated against the National Institutes of Health (2014) and British Society for Haematology (2018) guidelines. Data were analyzed using descriptive and inferential statistics.

Results: Sixty-seven (50.8%) of the 132 physicians had inadequate knowledge of hydroxyurea's clinical benefits and safety. Only 35 (26.5%) were aware of available treatment guidelines, and 32 (24.2%) had ever prescribed hydroxyurea. Among prescribers, nine (28.1%) used inappropriate criteria to initiate treatment and six (18.8%) prescribed below recommended doses. The median maximum daily prescribed dose was 750mg, whereas five (15.6%) physicians did not exceed 200mg, irrespective of patient weight. Treatment guidelines were not followed by 25 (78.1%) of prescribers.

Conclusion: This study revealed a high prevalence of inadequate knowledge and inconsistent hydroxyurea prescription practices among SCD care providers. Targeted training is essential to enhance hydroxyurea utilization and ensure adherence to standardized treatment guidelines, ultimately improving patient outcomes.

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