Adherence to hydroxyurea use among patients with sickle cell disease attending the sickle cell clinic at Mulago National Referral Hospital

Abstract

In Uganda, about 20,000 babies are born per year with sickle cell disease with a life expectancy of less than 20 years. Hydroxyurea was proven safe and effective by FDA to reduce frequency of complications due to SCD and preferred for treatment of SCD. This study aimed to determine level of adherence to hydroxyurea and associated factors among patients with sickle cell disease. A cross-sectional study was conducted with 221 caretakers recruited using consecutive sampling. Adherence was measured using the Morisky Medication Adherence-8 items and the visual analogue scales. Semi-structured questionnaires were used to assess the factors. Descriptive statistics was used to analyse data. The level of good adherence to hydroxyurea was low(8.60%). Key factors that influence adherence were marital status (OR=0.158, 95% CI=0.035-0.712, P=0.016), education level (OR=0.075, 95% CI=0.009-0.612, P=0.016), occupation (OR=3.916, 95% CI=1.091-14.052, P=0.036), access barriers (OR=4.014, 95% CI=1.269-12.702, P=0.018), and experiencing challenge with hydroxyurea (OR=0.322, 95% CI=0.124-0.840, P=0.021). Adherence to hydroxyurea was low. The most important factors that influence adherence to hydroxyurea were; marital status, education level, occupation, access barriers, and experiencing challenge with hydroxyurea. Findings suggest further research be made on interventions to remind patients and their caretakers to take Hydroxyurea as prescribed and also further research is needed on the subsidised prices