دورية أكاديمية
Barriers to Therapeutic Use of Hydroxyurea for Sickle Cell Disease in Nigeria: A Cross-Sectional Survey.
| العنوان: | Barriers to Therapeutic Use of Hydroxyurea for Sickle Cell Disease in Nigeria: A Cross-Sectional Survey. |
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| المؤلفون: | Okocha EC; Haematology Department, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria., Gyamfi J; Global Health Program and Department of Social and Behavioral Sciences, NYU School of Global Public Health, New York, NY, United States., Ryan N; Global Health Program and Department of Social and Behavioral Sciences, NYU School of Global Public Health, New York, NY, United States., Babalola O; Department of Biotechnology, Chrisland University, Abeokuta, Nigeria., Etuk EA; Centre of Excellence for Sickle Cell Disease Research and Training (CESRTA), University of Abuja, Abuja, Nigeria., Chianumba R; Centre of Excellence for Sickle Cell Disease Research and Training (CESRTA), University of Abuja, Abuja, Nigeria., Nwegbu M; Centre of Excellence for Sickle Cell Disease Research and Training (CESRTA), University of Abuja, Abuja, Nigeria., Isa H; Centre of Excellence for Sickle Cell Disease Research and Training (CESRTA), University of Abuja, Abuja, Nigeria., Madu AJ; Department of Haematology and Immunology, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria., Adegoke S; Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, Nigeria., Nnebe-Agumandu U; Centre of Excellence for Sickle Cell Disease Research and Training (CESRTA), University of Abuja, Abuja, Nigeria., Brown B; Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria., Peprah E; Global Health Program and Department of Social and Behavioral Sciences, NYU School of Global Public Health, New York, NY, United States., Nnodu OE; Centre of Excellence for Sickle Cell Disease Research and Training (CESRTA), University of Abuja, Abuja, Nigeria. |
| المصدر: | Frontiers in genetics [Front Genet] 2022 Jan 19; Vol. 12, pp. 765958. Date of Electronic Publication: 2022 Jan 19 (Print Publication: 2021). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Research Foundation Country of Publication: Switzerland NLM ID: 101560621 Publication Model: eCollection Cited Medium: Print ISSN: 1664-8021 (Print) Linking ISSN: 16648021 NLM ISO Abbreviation: Front Genet Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Lausanne : Frontiers Research Foundation. |
| مستخلص: | Background: Sickle cell disease, the inherited blood disorder characterized by anemia, severe pain and other vaso-occlusive complications, acute chest syndrome, disproportionate hospitalization, and early mortality, has significant financial, social, and psychosocial impacts and drains individuals, families, and health systems globally. Hydroxyurea could improve the health of the 300,000 individuals born each year with sickle cell disease in sub-Saharan Africa; however, challenges to adoption and adherence persist. This study assessed the barriers to therapeutic use of hydroxyurea for sickle cell disease within the Nigerian healthcare system, specifically from the level of the patient, provider, and health system. Methods: We used purposive sampling to recruit participants from 13 regions in Nigeria. A cross-sectional survey was administered to physicians ( n = 70), nurses or counselors ( n = 17), and patients or their caregivers ( n = 33) at 13 health centers. Findings were mapped onto the appropriate Consolidated Framework for Implementation Research (CFIR) domains. Results: This study was able to identify factors that mapped onto the inner setting, outer setting, and characteristics of individuals domains of CFIR. The majority of physicians (74.3%) prescribe hydroxyurea, and half stated hydroxyurea is the standard of care. Among clinicians, barriers included limited knowledge of the drug, as well as low self-efficacy to prescribe among physicians and to counsel among nurses; perceived side effects; perceived patient preference for traditional medicine; cost for patient and expense of accompanying laboratory monitoring; and limited availability of the drug and equipment for laboratory monitoring. Among patients and caregivers, barriers included lack of knowledge; perceived side effects; cost; religious beliefs of disease causation; and lack of pediatric formulation. Conclusions: Findings suggest that patient, provider, and health systems-level interventions are needed to improve hydroxyurea uptake among providers and adherence among patients with sickle cell disease in Nigeria. Interventions such as patient education, provider training, and policy change could address the disproportionate burden of sickle cell disease in sub-Saharan Africa and thus improve health equity. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Okocha, Gyamfi, Ryan, Babalola, Etuk, Chianumba, Nwegbu, Isa, Madu, Adegoke, Nnebe-Agumandu, Brown, Peprah and Nnodu.) |
| References: | J Natl Med Assoc. 2019 Apr;111(2):169-175. (PMID: 30314826) Health Soc Care Community. 2010 May;18(3):289-95. (PMID: 20113365) Ital J Pediatr. 2016 May 04;42(1):45. (PMID: 27146866) Global Health. 2021 Feb 17;17(1):20. (PMID: 33596947) Hemoglobin. 2017 Jul - Nov;41(4-6):267-273. (PMID: 29251012) Implement Sci. 2009 Aug 07;4:50. (PMID: 19664226) Afr Health Sci. 2017 Mar;17(1):255-261. (PMID: 29026400) PLoS Med. 2013;10(7):e1001484. (PMID: 23874164) Niger J Clin Pract. 2015 Jan-Feb;18(1):95-101. (PMID: 25511352) N Engl J Med. 1995 May 18;332(20):1317-22. (PMID: 7715639) PLoS One. 2021 Feb 17;16(2):e0246700. (PMID: 33596221) N Engl J Med. 2019 Jan 10;380(2):121-131. (PMID: 30501550) Int Health. 2014 Mar;6(1):23-8. (PMID: 24114193) J Trop Pediatr. 2020 Jun 1;66(3):290-298. (PMID: 31608959) Hemoglobin. 2019 May;43(3):188-192. (PMID: 31462098) |
| معلومات مُعتمدة: | U01 HL156942 United States HL NHLBI NIH HHS |
| فهرسة مساهمة: | Keywords: Nigeria; adoption; health care workers; hydroxyurea; sickle cell diasease |
| تواريخ الأحداث: | Date Created: 20220207 Latest Revision: 20220401 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC8807646 |
| DOI: | 10.3389/fgene.2021.765958 |
| PMID: | 35126450 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1664-8021 |
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| DOI: | 10.3389/fgene.2021.765958 |