Speaker
Description
Sickle Cell Disease (SCD) is an inherited disorder of the red blood cells with highest burden in sub-Saharan Africa. Approximately 1 in 100 persons have SCD in Ghana. SCD pain episodes can be reduced by the appropriate use of hydroxyurea (HU). Non-adherence to medication leads to increased health service utilization and costs and further impairs adherence and prognosis. Adherence assessment methods mostly involve laboratory tests which are expensive, and fraught with delays in low resource settings, but psychometric tools, which are quicker and cheaper, are hardly used. In Ghana, HU adherence has only been reported in Accra but no study has evaluated a psychometric tool specifically developed for HU adherence assessment. The study evaluated the adherence to HU using the Hydroxyurea Evaluation for Adherence for Life (HEAL) tool in paediatric SCD-SS patients and assessed the tool’s reliability and validity compared to the Mean Corpuscular Volume (MCV) values.
We enrolled all twenty-eight (28) patients, who had been on HU for at least six (6) months at the Komfo Anokye Teaching Hospital (KCSCD-KATH). Their pre and post HU initiation MCV values were obtained from their medical records and the HEAL tool was administered to their parents via phone call at enrolment and within 1-2 weeks of the initial call.
Adherence to HU was 43% on the HEAL scale and 18% on the MCV values. Internal consistency of the HEAL scale by Cronbach alpha was 0.88 and test-retest reliability correlation was 0.68(p-value:0.001). The HEAL scale correctly predicted 60% of adherence on the MCV scale. The HEAL scale can be used as a screening tool in Ghana to improve HU adherence and by extension benefit of HU.