Assessment of Iron Chelation Therapy Compliance among School Age Children with Thalassemia

Background: Iron overload is the most important cause of mortality in children with thalassemia major,iron chelation therapy (ICT) is therefore a critical issue in the management of these children, so compliance with ICT is crucial in preventing iron overload related complications.

Aim: The study aimed to assess compliance with (ICT) among school age children with thalassemia.

Method: A descriptive exploratory research design was utilized. Setting: this study was carried out at outpatient hematology clinicat Al-Mounira Pediatric Cairo-University Hospital.

Sample: A purposive sample of one hundred school age children with thalassemia.

Tool: The required data was collected by using structured interview questionnaire which consists of three parts to assess;child and caregiver personal data, child’s knowledge about thalassemia, blood transfusion and iron chelation therapy, compliance with iron chelation therapy and factors affecting compliance.

Results: More than three quarters of children their age ranged from 9 to 12 years old and nearly two thirds were males, one third of children received parenteral therapy Desferal, and about two thirds received oral chelators (Ferriprox and Exjade), the higher compliance rates were for children on Exjade,followed by Ferriprox, and thelowest compliance rates were for children on Desferal,the mean serum ferritin value was lowest in compliant children rather than non-compliant, also the lowest ferritin levels were in children on Exjade while the highest values were for children on Desferal.

Conclusion: More than half of children with thalassemia were compliant with ICT administration, compliance with oral chelators is better than parenteral and most of children prefer its convenience administration. The study recommended that factors affecting compliance with each iron chelation therapy must be examined to improve adherence to therapy through teaching.