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Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria

BACKGROUND: Hydroxyurea (HU) is an evidence-based therapy that is currently the most effective drug for sickle cell disease (SCD). HU is widely used in high-income countries with consequent reduction of morbidity and mortality. In Nigeria, HU is prescribed by physicians while nurses are mainly invol...

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Autores principales: Isa, Hezekiah Alkali, Nnebe-Agumadu, Uche, Nwegbu, Maxwell M., Okocha, Emmanuel C., Chianumba, Reuben I., Brown, Biobele J., Asala, Samuel A., Peprah, Emmanuel, Nnodu, Obiageli E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682971/
https://www.ncbi.nlm.nih.gov/pubmed/36355850
http://dx.doi.org/10.1371/journal.pone.0276639
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author Isa, Hezekiah Alkali
Nnebe-Agumadu, Uche
Nwegbu, Maxwell M.
Okocha, Emmanuel C.
Chianumba, Reuben I.
Brown, Biobele J.
Asala, Samuel A.
Peprah, Emmanuel
Nnodu, Obiageli E.
author_facet Isa, Hezekiah Alkali
Nnebe-Agumadu, Uche
Nwegbu, Maxwell M.
Okocha, Emmanuel C.
Chianumba, Reuben I.
Brown, Biobele J.
Asala, Samuel A.
Peprah, Emmanuel
Nnodu, Obiageli E.
author_sort Isa, Hezekiah Alkali
collection PubMed
description BACKGROUND: Hydroxyurea (HU) is an evidence-based therapy that is currently the most effective drug for sickle cell disease (SCD). HU is widely used in high-income countries with consequent reduction of morbidity and mortality. In Nigeria, HU is prescribed by physicians while nurses are mainly involved in counseling the patients to ensure adherence. The extent of utilization and the determinant factors have not been sufficiently evaluated in Nigeria. OBJECTIVE: To assess the frequency of use of HU and factors affecting utilization among healthcare providers, patients, and caregivers for SCD. METHODS: A questionnaire was administered online and in- person to assess the frequency of HU use and the factors that promote and limit its use. The data were analyzed by descriptive statistics using IBM SPSS software version 23 and the result was presented in frequency tables and percentages. RESULT: A total of 137 physicians, 137 nurses, and 237 patients/caregivers responded to the survey. The rate of prescription of HU by doctors in the past 6 months was 64 (46.7%), 43 (31.4%) nurses provided counseling and 36 (15.6%) patients were on HU. Among doctors, adequate knowledge (91.3%), clinical benefits and safety (94.8%), and inclusion of HU in management guidelines (86.9%) were motivators for prescribing it while inadequate knowledge (60.9%) and unawareness of treatment guidelines (68.6%) constituted barriers. Among nurses, reduction of crisis (91.6%) and safety (64.8%) were the major motivators while barriers were high cost (79.1%) and intensive monitoring (63.1%) of HU treatment. Among the patients, the major motivator was the reduction of crises (80.3%) while poor knowledge (93.2%), high cost of the drug (92.2%) while monitoring (91.2%), non-availability (87.7%) and side effects (83.9%) were the major barriers for the utilization of HU. CONCLUSION: HU prescription and utilization are still poor among healthcare providers and patients. Inadequate knowledge, non-availability and high cost of HU as well as unawareness of treatment guidelines constitute major barriers to prescription and utilization.
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spelling pubmed-96829712022-11-24 Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria Isa, Hezekiah Alkali Nnebe-Agumadu, Uche Nwegbu, Maxwell M. Okocha, Emmanuel C. Chianumba, Reuben I. Brown, Biobele J. Asala, Samuel A. Peprah, Emmanuel Nnodu, Obiageli E. PLoS One Research Article BACKGROUND: Hydroxyurea (HU) is an evidence-based therapy that is currently the most effective drug for sickle cell disease (SCD). HU is widely used in high-income countries with consequent reduction of morbidity and mortality. In Nigeria, HU is prescribed by physicians while nurses are mainly involved in counseling the patients to ensure adherence. The extent of utilization and the determinant factors have not been sufficiently evaluated in Nigeria. OBJECTIVE: To assess the frequency of use of HU and factors affecting utilization among healthcare providers, patients, and caregivers for SCD. METHODS: A questionnaire was administered online and in- person to assess the frequency of HU use and the factors that promote and limit its use. The data were analyzed by descriptive statistics using IBM SPSS software version 23 and the result was presented in frequency tables and percentages. RESULT: A total of 137 physicians, 137 nurses, and 237 patients/caregivers responded to the survey. The rate of prescription of HU by doctors in the past 6 months was 64 (46.7%), 43 (31.4%) nurses provided counseling and 36 (15.6%) patients were on HU. Among doctors, adequate knowledge (91.3%), clinical benefits and safety (94.8%), and inclusion of HU in management guidelines (86.9%) were motivators for prescribing it while inadequate knowledge (60.9%) and unawareness of treatment guidelines (68.6%) constituted barriers. Among nurses, reduction of crisis (91.6%) and safety (64.8%) were the major motivators while barriers were high cost (79.1%) and intensive monitoring (63.1%) of HU treatment. Among the patients, the major motivator was the reduction of crises (80.3%) while poor knowledge (93.2%), high cost of the drug (92.2%) while monitoring (91.2%), non-availability (87.7%) and side effects (83.9%) were the major barriers for the utilization of HU. CONCLUSION: HU prescription and utilization are still poor among healthcare providers and patients. Inadequate knowledge, non-availability and high cost of HU as well as unawareness of treatment guidelines constitute major barriers to prescription and utilization. Public Library of Science 2022-11-10 /pmc/articles/PMC9682971/ /pubmed/36355850 http://dx.doi.org/10.1371/journal.pone.0276639 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Isa, Hezekiah Alkali
Nnebe-Agumadu, Uche
Nwegbu, Maxwell M.
Okocha, Emmanuel C.
Chianumba, Reuben I.
Brown, Biobele J.
Asala, Samuel A.
Peprah, Emmanuel
Nnodu, Obiageli E.
Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria
title Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria
title_full Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria
title_fullStr Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria
title_full_unstemmed Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria
title_short Determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in Nigeria
title_sort determinants of hydroxyurea use among doctors, nurses and sickle cell disease patients in nigeria
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682971/
https://www.ncbi.nlm.nih.gov/pubmed/36355850
http://dx.doi.org/10.1371/journal.pone.0276639
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