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Intentional and unintentional nonadherence to hydroxyurea among people with sickle cell disease: a qualitative study.
Hodges, Jason R; Phillips, Shannon M; Norell, Sarah; Nwosu, Chinonyelum; Khan, Hamda; Luo, Lingzi; Badawy, Sherif M; King, Allison; Tanabe, Paula; Treadwell, Marsha; Rojas Smith, Lucia; Calhoun, Cecelia; Hankins, Jane S; Porter, Jerlym.
Afiliação
  • Hodges JR; Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN.
  • Phillips SM; College of Nursing, Medical University of South Carolina, Charleston, SC.
  • Norell S; Institute of HealthCare Delivery Design, University of Illinois, Chicago, IL.
  • Nwosu C; Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN.
  • Khan H; Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN.
  • Luo L; School of Medicine, Washington University in St. Louis, St. Louis, MO.
  • Badawy SM; Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
  • King A; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
  • Tanabe P; School of Medicine, Washington University in St. Louis, St. Louis, MO.
  • Treadwell M; School of Nursing and Medicine, Duke University, Durham, NC.
  • Rojas Smith L; Department of Hematology/Oncology, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, CA.
  • Calhoun C; Center for Evaluation, Policy and Implementation Research, RTI International, Durham, NC; and.
  • Hankins JS; School of Medicine, Washington University in St. Louis, St. Louis, MO.
  • Porter J; Department of Hematology, St. Jude Children's Research Hospital, Memphis, TN.
Blood Adv ; 4(18): 4463-4473, 2020 09 22.
Article em En | MEDLINE | ID: mdl-32941646
Hydroxyurea is an efficacious treatment for sickle cell disease (SCD), but adoption is low among individuals with SCD. The objective of this study was to examine barriers to patients' adherence to hydroxyurea use regimens by using the intentional and unintentional medication nonadherence framework. We interviewed individuals with SCD age 15 to 49.9 years who were participants in the Sickle Cell Disease Implementation Consortium (SCDIC) Needs Assessment. The intentional and unintentional medication nonadherence framework explains barriers to using hydroxyurea and adds granularity to the understanding of medication adherence barriers unique to the SCD population. In total, 90 semi-structured interviews were completed across 5 of the 8 SCDIC sites. Among interviewed participants, 57.8% (n = 52) were currently taking hydroxyurea, 28.9% (n = 26) were former hydroxyurea users at the time of the interview, and 13.3% (n = 12) had never used hydroxyurea but were familiar with the medication. Using a constructivist grounded theory approach, we discovered important themes that contributed to nonadherence to hydroxyurea, which were categorized under unintentional (eg, Forgetfulness, External Influencers) and intentional (Negative Perceptions of Hydroxyurea, Aversion to Taking Any Medications) nonadherence types. Participants more frequently endorsed adherence barriers that fell into the unintentional nonadherence type (70%) vs intentional nonadherence type (30%). Results from this study will help SCD health care providers understand patient choices and decisions as being either unintentional or intentional, guide tailored clinical discussions regarding hydroxyurea therapy, and develop specific, more nuanced interventions to address nonadherence factors.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hidroxiureia / Anemia Falciforme Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Adolescent / Adult / Humans / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hidroxiureia / Anemia Falciforme Tipo de estudo: Prognostic_studies / Qualitative_research Limite: Adolescent / Adult / Humans / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article