Understanding the consequences of poor chelation compliance is crucial
given the enormous burden of post-transfusional iron overload
complications. We systematically reviewed iron-chelation therapy (ICT)
compliance, and the relationship between compliance with health outcome
and health-related quality of life (HRQoL) in thalassaemia patients.
Several reviewers performed systematic search strategy of literature
through PubMed, Scopus, and EBSCOhost. The preferred reporting items of
systematic reviews and meta-analyses (PRISMA) guidelines were followed.
Of 4917 studies, 20 publications were included. The ICT compliance rate
ranges from 20.93% to 75.3%. It also varied per agent, ranging from
48.84-85.1% for desferioxamine, 87.2-92.2% for deferiprone and
90-100% for deferasirox. Majority of studies (N=10/11, 90.91%)
demonstrated significantly negative correlation between compliance and
serum ferritin, while numerous studies revealed poor ICT compliance
linked with increased risk of liver disease (N=4/7, 57.14%) and cardiac
disease (N=6/8, 75%), endocrinologic morbidity (N=4/5, 90%), and lower
HRQoL (N=4/6, 66.67%). Inadequate compliance with ICT therapy is
common. Higher compliance is correlated with the lower serum ferritin,
lower risk of complications, and higher HRQoL. These findings should be
interpreted with caution given the few numbers of evidence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.