title: Satisfaction and adherence in patients with iron overload receiving iron chelation therapy as assessed by a newly developed patient instrument.
abstract: OBJECTIVE
  This study assesses satisfaction with iron chelation therapy (ICT) based on a reliable and valid instrument, and explores the relationship between satisfaction and adherence to ICT.
  
  
  METHODS
  Patients in the USA and UK completed a new "Satisfaction with ICT" (SICT) instrument consisting of 28 items, three pertaining to adherence. Simple and multivariate regression analyses assessed the relationship between satisfaction with different aspects of ICT and adherence.
  
  
  RESULTS
  First assessments of the SICT instrument indicate its validity and reliability. Recommended thresholds for internal consistency, convergent validity, discriminant validity, and floor and ceiling effects were met. A number of variables were identified in the simple linear regression analyses as significant predictors of "never thinking about stopping ICT," a proxy for adherence. These significant variables were entered into the multivariate model to assess the combined factor effects, explaining 42% of the total variance of "never thinking about stopping ICT." A significant and positive relationship was demonstrated between "never thinking about stopping ICT" and age (P = 0.04), Perceived Effectiveness of ICT (P = 0.003), low Burden of ICT (P = 0.002), and low Side Effects of ICT (P = 0.01).
  
  
  CONCLUSIONS
  The SICT is a reliable and valid instrument which will be useful in ICT clinical trials. Furthermore, the administration of ICT by slow subcutaneous infusion negatively impacts on satisfaction with ICT which was shown to be a determinant of adherence. This points to the need for new more convenient and less burdensome oral iron chelators to increase adherence, and ultimately to improve patient outcomes.
authors.affiliation: Mapi Values, Bollington, Cheshire, UK. diana.rofail@mapivalues.com
authors.forename: Diana
authors.initials: D
authors.lastname: Rofail
authors.forename: Linda
authors.initials: L
authors.lastname: Abetz
authors.forename: Muriel
authors.initials: M
authors.lastname: Viala
authors.forename: Claire
authors.initials: C
authors.lastname: Gait
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Baladi
authors.forename: Krista
authors.initials: K
authors.lastname: Payne
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001565:Benzoates / Q000008:administration & dosage*; D000077588:Deferasirox; D005260:Female; D006801:Humans; D007502:Iron Chelating Agents / Q000008:administration & dosage*; D019190:Iron Overload / Q000628:therapy*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D014230:Triazoles / Q000008:administration & dosage*; D006113:United Kingdom; D014481:United States; D055815:Young Adult
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D000077588:Deferasirox