Adherence to Iron Chelation Therapy and Its Determinants

Background: thalassemia is a chronic disease requiring lifelong treatment. the adherence to regular iron chelation therapy is important to ensure complication-free survival and good quality of life. the study aim to assess the adherence to iron chelation therapy (ict) in patients with transfusion-dependent thalassemia (tdt), evaluate various causes of non-adherence and study the impact of non-adherence on the prevalence of complications secondary to iron overload. materials and methods: patients with tdt on ict for > 6 months were enrolled in the study. hospital records were reviewed for demographic details, iron overload status, treatment details, and the prevalence of complications. a study questionnaire was used to collect information on adherence to ict, knowledge of patients, and the possible reasons for non-adherence. results: a total of 215 patients with a mean age of 15.07+7.68 years and an m: f ratio of 2.2:1 were included in the study. non-adherence to ict was found in 10.7% of patients. serum ferritin levels were significantly higher in the non-adherent group (3129.8+1573.2 μg/l) than the adherent population (2013.1+1277.1 μg/l). cardiac as well as severe liver iron overload was higher in the non-adherent patients. no correlation was found between disease knowledge and adherence to ict. difficulties in drug administration and many medicines to be taken daily were statistically significant reasons for non-adherence. there was no difference in the co-morbidities arising due to the iron overload in the two groups. conclusion: nearly 11% of patients with tdt were non-adherent to ict. non-adherence results in higher iron overload.