A Study of Knowledge about Deferasirox and Behavior of Taking Deferasirox in Patients with β-Thalassemia Major
Date Issued
2012
Date
2012
Author(s)
Mei, Pei-Yi
Abstract
Background: Patients with β-thalassemia major require life-long periodic blood transfusions for treatment due to abnormal hematopoietic function. Among all the side effects derived from blood transfusion, organ failure caused by hemochromatosis is the most common cause leading to death. Deferasirox (Exjade) was approved for marketing in the Unites States and Europe in 2005. In 2007, it was approved in Taiwan to be covered by National Health Insurance. This study intended to investigate whether the administration of once-daily oral iron chelator can improve patients’ drug-taking behavior.
Purposes: There are three detailed purpose. 1. To understand patients’ knowledge of drug and the current status of their drug-taking behavior; 2. to analyze the differences in patients’ basic information, knowledge of drug, and drug-taking behavior; and 3. to analyze the correlation between patients’ knowledge of drug and drug-taking behavior.
Methods: This is a correlation and cross-sectional research. By purposive sampling, this study administered self-developed scales to investigate the knowledge of drug and drug-taking behavior of oral iron chelator, Deferasirox, and their correlation in patients with β-thalassemia major. The research site was the special outpatient clinic for β-thalassemia major at the National Taiwan University Hospital. This study enrolled the patients meeting the inclusion criteria and agreeing to participate in this study as the subjects. 42 patients were actually enrolled.
Tools: A self-developed questionnaire of the knowledge of drug was used to conduct a questionnaire survey. The questionnaire included a total of 10 items, such as mechanism of drug, side effects, medication method, and notices. Moreover, a 12-item drug-taking behavior scale was also used as the research tool.
Results: In terms of patients’ score of knowledge of drug, the score ranged from 5 to 10 points. The total score was 10 points, and the average score was 8.43±1.34 points. The total score of drug-taking behavior was 60 points. The score ranged from 35 to 57 points, and the average score was 45.29±4.47 points. The results showed that both patients’ knowledge of drug and drug-taking behavior should be improved. The test on the difference between patients’ basic properties and knowledge of drug showed that a significant difference was only found in the result of knowledge of drug in patients complicated by hemochromatosis (t=-2.37, P=0.02*). In other words, patients complicated by hemochromatosis had better knowledge of drug. The result of the test on the difference between patients’ basic properties and drug-taking behavior showed that age had a significant effect (F=3.89, P=0.01*) on patients’ drug-taking behavior. However, the result of Scheffé’s post hoc comparison showed that there was no significant difference in drug-taking behavior among various groups. Besides, the latest serum iron centration had a significant effect on drug-taking behavior (F=3.73, P=0.01*). The result of Scheffé’s post hoc comparison showed that the latest serum iron concentration (the patients whose serum iron concentration ≦ 2000 mg/dl, and those whose serum iron concentration between 2001 mg/dl and 4000 mg/dl, and those whose serum iron concentration ≧ 4001 mg/dl) three groups did not have a significant difference on drug-taking behavior. The Cronbach’s α coefficient of the questionnaire on knowledge of drug was 0.44, and that of the questionnaire on drug-taking behavior was 0.29. The reliability of the two questionnaires was lower than the acceptable level. Therefore, it was impossible to perform correlation analysis.
Discussions: Discussions: Based on the findings of current study, indicating the patient''s general knowledge level is below the satisfactory level, the patient''s drug-taking behavior still needs improvement in this study. The main factor is “unable to see immediate feedback”, which probably reduces the attitude to take medication. It need to research further.
Conclusions: The results of the study could be used to assist clinical nursing personnel in finding out the deficiencies of patients, improve their deficiencies, and propose effective strategies to handle them.
Subjects
β-thalassemia major
oral form of iron chelator
knowledge of drug
drug-taking behavior
Type
thesis
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