Monitoring toxicity, impact, and adherence of hydroxyurea in children with sickle cell disease.
Monitoring toxicity, impact, and adherence of hydroxyurea in children with sickle cell disease.
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DOI：
10.1002/ajh.22101
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发表时间：
2011-09
影响因子：
12.8
通讯作者：
Panepinto, Julie A.
中科院分区：
文献类型：
--
作者：
Brandow, Amanda M.;Panepinto, Julie A.
在镰状细胞病(SCD)中，羟基尿素(HU)利用不足。患者坚持服用HU并接受所需的药物监测是提供者认为HU使用的障碍。为了确定可能导致这些障碍的过程问题，我们试图：1)描述临床实践中提供者如何监测和调整SCD儿童的HU剂量；2)确定提供者评估HU依从性的方法。一项试点测试的调查通过电子邮件发送给了美国儿科血液/肿瘤学会(ASPHO)的成员。进行描述性统计。在1128份调查中，31%(n=350)被收回；63%(350名受访者中的220名)为患有SCD的儿童提供护理。大多数提供者(64.7%)每月跟踪实验室，近一半(41.9%)每月见病人。大多数(61.9%)使用最大耐受剂量调整HU剂量，通常使用ANC(27.9%)、血小板(26.5%)和WBC计数(11.2%)。依从性主要通过患者访谈(84.2%)、MCV(75.3%)和HBF水平(70.7%)进行评估。大多数供应商每月进行监测，并使用不可靠的方法评估HU遵守情况。确定监测HU的最佳频率和更可靠的评估遵守情况的方法，对于平衡安全性和消除障碍以促进HU的利用至关重要。
Hydroxyurea (HU) is underutilized in sickle cell disease (SCD). Patient adherence with taking HU and with required drug monitoring is a provider perceived barrier to HU utilization. To determine process issues that may contribute to these barriers we sought to: 1) describe how providers monitor and adjust HU dosing in children with SCD in clinical practice and 2) identify providers' methods of assessing HU adherence. A pilot-tested survey was emailed to American Society of Pediatric Hematology/Oncology (ASPHO) members. Descriptive statistics were performed. Thirty-one percent (n=350) of 1128 surveys were returned; 63% (220 of 350) of respondents provided care for children with SCD. Most providers (64.7%) follow labs monthly and almost half (41.9%) see patients monthly. The majority (61.9%) adjusted HU dosing using maximum tolerated dose commonly determined using ANC (27.9%), platelets (26.5%), and WBC count (11.2%). Adherence was primarily assessed using patient interview (84.2%), MCV (75.3%), and HbF levels (70.7%). The majority of providers perform monthly monitoring and assess HU adherence using unreliable methods. Determining optimal frequency of monitoring HU and more reliable methods of assessing adherence are essential to balancing safety and the elimination of barriers to promote HU utilization.
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影响因子：
12.4
作者：
Jentzsch, N. S.;Camargos, P. A. M.;Bousquet, J.
通讯作者：
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