Do difficulties in swallowing medication impede the use of hydroxyurea in children?
Do difficulties in swallowing medication impede the use of hydroxyurea in children?
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DOI：
10.1002/pbc.25073
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发表时间：
2014-09
影响因子：
3.2
通讯作者：
Green, Nancy S.
中科院分区：
文献类型：
--
作者：
Bekele, ElShadey;Thornburg, Courtney D.;Brandow, Amanda M.;Sharma, Mukta;Smaldone, Arlene M.;Jin, Zhezhen;Green, Nancy S.
羟基尿素(HU)在儿童镰状细胞病(SCD)中的使用可能会受到胶囊形式和液体HU可获得性有限的限制。在四个儿童SCD诊所，对5-17岁SCD儿童的父母进行了调查，了解他们孩子的药物使用情况和吞咽药物的能力。数据按HU疗法分层，采用描述性统计、卡方检验、Fisher精确检验和单因素分析进行分析。在接受调查的116名父母中，97%是主要的照顾者。四分之一(26%)的父母报告说，他们的孩子吞咽药物的困难干扰了日常药物的使用。与年龄相关的差异被发现在吞咽药物的能力上，但不是通过HU使用。服用HU的儿童更有可能每天服用多种药物，剂量计划更频繁。在65名HU使用者中，使用液体制剂的儿童(28%，n=18)比使用胶囊的儿童(P<；0.0001)年轻。然而，液体HU使用者中有一半的人年龄在8-13岁之间。使用HU液体胶囊的儿童比使用HU胶囊的儿童更容易吞咽药物(OR4.29，95%CI1.14-16.18，P=0.032)。很少有人接受过吞咽药物的培训。四分之一的受访父母认为吞咽对日常用药具有挑战性。这些发现表明，胶囊吞咽困难是儿童服用HU的一个相当常见的障碍，特别是对年幼的儿童。在日常和更复杂的用药计划的家庭中，HU的使用似乎更有可能。指导吞服胶囊可提高HU的利用率和依从性。
Use of hydroxyurea (HU) in children with sickle cell disease (SCD) may be hampered by its formulation as a capsule and the limited availability of liquid HU. At four Pediatric SCD clinics, parents of children with SCD ages 5–17 years were surveyed about their children’s medication use and ability to swallow medication. Data were stratified by HU therapy and analyzed using descriptive statistics, Chi square tests, Fisher exact tests and univariate analysis. Of the 116 parents surveyed, 97% were the primary caregiver. One fourth (26%) of parents reported that their child’s difficulty swallowing medication interfered with daily medication use. Age-related differences were found in ability to swallow medication, but not by HU use. Children taking HU were more likely to take multiple daily medications, with more frequent dosing schedules. Among 65 HU users, children using the liquid formulation (28%, n =18) were younger than capsule users (P <0.0001). Nonetheless, half of liquid HU users were aged 8–13. Children using liquid HU were more likely to have difficulties swallowing medication than those who use HU capsules (OR 4.29, 95% CI 1.14–16.18, P =0.032). Few had received training for swallowing medication. One fourth of surveyed parents viewed swallowing as challenging to daily medication use. These findings suggest that difficulty swallowing capsules is a fairly frequent barrier to for children prescribed HU, especially for younger children. HU use appears more likely in families with daily and more complex medication schedules. Coaching for swallowing capsules may improve HU utilization and adherence.
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影响因子：
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