EFICACIA Y ADHERENCIA A LA HIDROXIUREA EN NIÑOS Y ADOLESCENTES CON ANEMIA DE CÉLULAS FALCIFORMES

• DOI: 10.22533/at.ed.14322071012

• Palavras-chave: -

• Keywords: Hydroxyurea, sickle-cell anemia, adherence, effectiveness

• Abstract:

  Hydroxyurea (HU) is a drug that has demonstrated improvement in the clinical severity of patients with sickle cell anemia but in many cases its effectiveness is related to adherence and accessibility to treatment. Although HU is an inexpensive drug, many low-income countries still have problems acquiring it. Objective: To determine the clinical and laboratory effectiveness and relate it with the degree of adherence to treatment with hydroxyurea in patients with sickle cell anemia who attend to the hematology outpatient clinic at the Dr. Robert Reid Cabral Children's Hospital. Methods: An observational, descriptive, cross-sectional study was carried out during the months of January-June 2019. The population consisted of 99 children and adolescents diagnosed with sickle cell disease who attended the outpatient clinic during the study period and had prescribed hydroxyurea.  95 patients met the inclusion criteria. Clinical effectiveness was measured in proportion to the reduction in the number of vasa-occlusive crisis episodes per year, admissions, and complications. Laboratory effectiveness is reflected in the variation of blood count values before and after HU. To assess adherence to treatment, the information methodology provided by the SMAQ Compliance Test (The Medication Adherence Questionnaire) was used. Results: 76.8% of the patients had a high effectiveness in the clinical response. 75.8% of the patients had a high and medium effectiveness in the laboratory parameters. 62.1% of assessed patients have presented poor adherence to treatment with HU. The main cause of poor adherence was forgetting to take the medication followed by the difficulty of acquiring them due to the cost and accessibility.  Most of the patients (61%) did not present side effects with treatment.

  Conclusion: Despite low adherence, Hydroxyurea turned out to be very effective and with few side effects. Better public health policies should be established to improve access to treatment in low-income patients.