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Correlation between barriers to adherence and treatment satisfaction of hydroxyurea in individuals with sickle cell disease

Vaidyanathan, Anusha (2015) Correlation between barriers to adherence and treatment satisfaction of hydroxyurea in individuals with sickle cell disease. Master's Thesis, University of Pittsburgh. (Unpublished)

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Sickle cell Disease (SCD) is an autosomal recessive disorder that affects 50,000 to 100,000 people in the United States. This disorder is characterized by pain episodes, acute chest syndrome, splenic sequestration, infection, stroke, aplastic crisis, and priapism. Hydroxyurea (HU) is a drug that is clinically effective in reducing pain episodes, hospitalizations, and total health care costs. However, studies show that HU continues to be underutilized in individuals with SCD. There is evidence to suggest poor adherence to HU among people in this population and studies have identified a number of barriers at the patient, caregiver, provider and system wide levels. Issues with adherence strongly impacts Health Related Quality of Life (HRQOL) of individuals with SCD, making it a public health concern. While there are reports available in the literature on the qualitative analyses of barriers experienced by this population, there have been no known studies that have examined patient reported treatment satisfaction. Our hypothesis is that barriers to adherence of HU and treatment satisfaction play a significant role in medication adherence.
The objective is three-fold:
1. To determine the barriers to adherence of hydroxyurea for individuals with SCD
2. To determine the treatment satisfaction of hydroxyurea in individuals with SCD
3. To determine any correlation between the treatment satisfaction and the barriers to HU

The participants in this study include individuals who have been on HU for at least 6 months. Pediatric, caregiver and adult participants were recruited from the University of Pittsburgh Medical Center and Children’s Healthcare of Atlanta. Only adult participants were recruited from Children’s National Medical Center, Washington DC. The information was collected using two surveys administered to all individuals. The TSQM-9 (Treatment Satisfaction Questionnaire for Medication) was used to evaluate Hydroxyurea treatment satisfaction in patients. The Adherence Starts with Knowledge (ASK-12) survey along with the additional barriers survey were used to evaluate the barriers to adherence of Hydroxyurea. All surveys were modified for caregiver responses in the pediatric settings. The surveys were administered over a period of one year.
The results of this study revealed low levels of barriers and moderately high levels of treatment satisfaction. The survey results indicate that two specific questions present in the additional barriers surveys may be examined in greater detail. Weak linear correlation was observed between several categories of barrier surveys and the subsets of the treatment satisfactions survey.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Vaidyanathan, AnushaANV48@pitt.eduANV480000-0001-8510-413X
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairKrishnamurti,
Committee MemberKato, Gregory Jkatogj@upmc.eduGJK22
Committee MemberShaffer, John Rjrs51@pitt.eduJRS51
Committee MemberMartinson, Jeremy Jjmartins@pitt.eduJMARTINS
Committee MemberGrubs, Robinrgrubs@pitt.eduRGRUBS
Date: 28 September 2015
Date Type: Publication
Defense Date: 11 August 2015
Approval Date: 28 September 2015
Submission Date: 31 August 2015
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 88
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Genetic Counseling
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: N/A
Date Deposited: 28 Sep 2015 18:38
Last Modified: 19 Dec 2016 14:42


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