PMID- 31462098

OWN - NLM
STAT- Publisher
LR - 20190829
IS - 1532-432X (Electronic)
IS - 0363-0269 (Linking)
DP - 2019 Aug 29
TI - Barriers to the use of hydroxyurea in the management of sickle cell disease
in
Nigeria.
PG - 1-5
LID - 10.1080/03630269.2019.1649278 [doi]
AB - Hydroxyurea (HU) is a well-known Hb F-inducing agent with proven clinical and
laboratory efficacy for patients with sickle cell disease. However, concerns
about its long-term safety and toxicity have limited its prescription by
physicians and acceptability by patients. Thus, this study aims to evaluate
clinician's barriers to the use of HU in the management of patients with
sickle
cell disease in Nigeria. An online survey targeted physicians in pediatrics,
hematology, medicine, family medicine and general medical practice managing
sickle cell disease in Nigeria. The survey was in four sections: demographic,
knowledge and experience with HU, and barriers to the use of HU. Ninety-one
(73.0%) of 123 contacts completed the survey. Seventy-three percent and 74.0%
of
the respondents noted that HU reduced transfusion rates and improved overall
quality of life (QOL) of patients, respectively. While the majority of the
practitioners (55.6%) see between 10-50 patients per month, most (66.7%)
write <5
prescriptions for HU per month. Lack of a national guideline for use of HU,
especially in children (52.0%), concern for infertility (52.0%), and safety
profile of HU in pregnancy and lactation (48.2%), top the factors considered
by
the respondents as major barriers to the use of HU. Hydroxyurea is grossly
under
prescribed in Nigeria, despite that the vast majority of physicians who
attend
patients with sickle cell disease know about its clinical efficacy.
Evidence-based clinical practice guidelines could be explored as a way to
standardize practices and improve confidence of practitioners to improve
physicians' prescription of HU in the management of sickle cell disease.
FAU - Adeyemo, Titilope A
AU - Adeyemo TA
AUID- ORCID: http://orcid.org/0000-0003-2097-469X
AD - Department of Haematology and Blood Transfusion, College of Medicine,
University
of Lagos , Lagos , Nigeria.
AD - Department of Haematology and Blood Transfusion, Lagos University Teaching
Hospital , Id-Aarba , Lagos , Nigeria.
FAU - Diaku-Akinwunmi, Ijeoma N
AU - Diaku-Akinwunmi IN
AD - Department of Paediatrics, Lagos State College of Medicine , Ikeja , Lagos ,
Nigeria.
FAU - Ojewunmi, Oyesola O
AU - Ojewunmi OO
AD - DNA Laboratory, Sickle Cell Foundation Nigeria , Lagos , Nigeria.
FAU - Bolarinwa, Abiola B
AU - Bolarinwa AB
AD - Department of Haematology and Blood Transfusion, Lagos University Teaching
 Hospital , Id-Aarba , Lagos , Nigeria.
FAU - Adekile, Adekunle D
AU - Adekile AD
AD - Department of Paediatrics, Faculty of Medicine, Kuwait University , Kuwait
City ,
Kuwait.
LA - eng
PT - Journal Article
DEP - 20190829
PL - England
TA - Hemoglobin
JT - Hemoglobin
JID - 7705865
SB - IM
OTO - NOTNLM
OT - Acceptability
OT - Nigeria
OT - hydroxyurea (HU)
OT - sickle cell anemia
OT - toxicity
EDAT- 2019/08/30 06:00
MHDA- 2019/08/30 06:00
CRDT- 2019/08/30 06:00
PHST- 2019/08/30 06:00 [entrez]
PHST- 2019/08/30 06:00 [pubmed]
PHST- 2019/08/30 06:00 [medline]
AID - 10.1080/03630269.2019.1649278 [doi]
PST - aheadofprint
SO - Hemoglobin. 2019 Aug 29:1-5. doi: 10.1080/03630269.2019.1649278.