Nghiên cứu sự tuân thủ điều trị thải sắt của bệnh nhân thalassemia tại bệnh viện Huyết học - Truyền máu Thành phố Cần Thơ=Study on adherence to iron chelation therapy among thalassemia patients treated at the Hematology and Blood Transfusion hospital of Can Tho city

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Tác giả: Thị Huệ Bùi, Tấn Hải Hà, Thị Thanh Tú Lê, Xuân Việt Nguyễn, Thị Tâm Phạm, Văn Nghĩa Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.681-688

Bộ sưu tập: Metadata

ID: 478347

Thêm vào giỏ

Iron chelation is a major treatment for thalassemia patients besides blood transfusion. Iron chelation requires continuous, long-term and high cost, so most patients find it difficult to comply. As a result, many patients have severe iron overload. In Vietnam, we have not recorded any studies addressing the issue of compliance with iron chelation treatment and factors related to compliance. Subjects and methods: Cross-sectional descriptive study with analysis on 165 patients and interventional study, without control group on 151 thalassemia patients with indications for iron chelation who are being treated at Can Tho Hematology - Blood Transfusion Hospital. Results: Patients with severe iron overload accounted for the majority (64.8%). The median compliance rate was 24.0%. Patients with income over 2 million VND complied more than those with income under 2 million VND (OR=3.7, p=0.03). The group of patients with correct knowledge complied with iron chelation more than the group of patients with incorrect knowledge with an OR of 3.8 (p<
0.05). Compliance reduced heavy iron overload with an OR of 0.3 (p=0.01). After the intervention, patient knowledge increased by 80.0%, the compliance rate increased by 42.1% compared to before the intervention. Conclusion: The majority of thalassemia patients with indications for iron chelation treatment had heavy iron overload. The compliance rate for iron chelation treatment in thalassemia patients was low. Good economic conditions and correct knowledge helped patients comply with iron chelation more. Compliance reduced the level of heavy iron overload compared to non-compliance. Interventions with communication counseling and education on iron chelation knowledge increased thalassemia patients' knowledge and compliance with iron chelation treatment.Thải sắt là một phương cách điều trị chủ yếu của bệnh nhân thalassemia bên cạnh truyền máu. Thải sắt cần phải liên tục, lâu dài và chi phí cao nên phần lớn bệnh nhân khó tuân thủ. Hậu quả là rất nhiều bệnh nhân ứ sắt mức độ nặng. Tại Việt Nam, chúng tôi chưa ghi nhận có nghiên cứu đề cập vấn đề tuân thủ điều trị thải sắt và các yếu tố liên quan đến việc tuân thủ. Đối tượng, phương pháp: Nghiên cứu mô tả cắt ngang có phân tích trên 165 bệnh nhân và nghiên cứu can thiệp, không nhóm chứng trên 151 bệnh nhân thalassemia có chỉ định thải sắt đang điều trị bệnh viện Huyết học -Truyền máu Cần Thơ. Kết quả: Bệnh nhân ứ sắt nặng chiếm đa số (64,8%). Tỷ lệ tuân thủ trung vị là 24,0%. Nhóm bệnh nhân có thu nhập trên 2 triệu đồng tuân thủ nhiều hơn thu nhập dưới 2 triệu đồng (OR=3,7, p=0,03). Nhóm bệnh nhân có kiến thức đúng tuân thủ thải sắt nhiều hơn nhóm bệnh nhân có kiến thức không đúng với OR là 3,8 (p<
0,05). Tuân thủ làm giảm ứ sắt nặng với OR là 0,3 (p=0,01). Sau can thiệp, kiến thức bệnh nhân tăng 80,0%, tỷ lệ tuân thủ tăng thêm 42,1% so với trước can thiệp. Kết luận: Đa số bệnh nhân thalassmia có chỉ định điều trị thải sắt có mức ứ sắt nặng. Tỷ lệ tuân thủ điều trị thải sắt trên bệnh nhân thalassemia thấp. Kinh tế khá và kiến thức đúng giúp bệnh nhân tuân thủ thải sắt nhiều hơn. Sự tuân thủ làm giảm mức độ ứ sắt nặng so với không tuân thủ. Can thiệp tư vấn truyền thông, giáo dục kiến thức thải sắt làm cho bệnh nhân thalassemia gia tăng kiến thức và sự tuân thủ điều trị thải sắt.

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