title: Challenges of adherence and persistence with iron chelation therapy.
abstract: Due to advances in medical sciences, many chronic diseases that formerly resulted in early death can now be effectively managed with long-term treatment regimens. Patients with potentially fatal anemias, for example, can be treated with ongoing blood transfusions and iron chelation therapy. Ensuring adherence and persistence is challenging, as the benefits of therapy are not perceived immediately. Poor adherence severely compromises the effectiveness of treatment and, therefore, improving compliance in terms of quality of life and health economics is critical. Although adherence to chelation therapy is generally poor, the availability of oral iron chelators may help to improve patient compliance. For chronic conditions such as thalassemia major, even when oral chelation therapy is available, support by an integrated team including a clinical psychologist and nurse specialist working with the treatment center is recommended to achieve optimal results.
authors: Department of Haematology, University College London, UCL Cancer Institute, Paul O'Gorman Building, 72 Huntley Street, London WC1E 6BT, UK. j.porter@ucl.ac.uk
authors: John B
authors: JB
authors: Porter
authors: Michael
authors: M
authors: Evangeli
authors: Amal
authors: A
authors: El-Beshlawy
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000188:drug therapy / Q000523:psychology; D001565:Benzoates / Q000008:administration & dosage*; D002648:Child; D000077588:Deferasirox; D000077543:Deferiprone; D003676:Deferoxamine / Q000008:administration & dosage*; D004304:Dosage Forms; D006801:Humans; D007262:Infusions, Intravenous; D007502:Iron Chelating Agents / Q000008:administration & dosage*; D019190:Iron Overload / Q000188:drug therapy* / Q000523:psychology*; D010348:Patient Care Team; D010349:Patient Compliance; D011728:Pyridones / Q000008:administration & dosage*; D013997:Time Factors; D014230:Triazoles / Q000008:administration & dosage*; D017086:beta-Thalassemia / Q000188:drug therapy / Q000523:psychology
chemical_list: D001565:Benzoates; D004304:Dosage Forms; D007502:Iron Chelating Agents; D011728:Pyridones; D014230:Triazoles; D000077543:Deferiprone; D003676:Deferoxamine; D000077588:Deferasirox