Assessing hydroxyurea use in sickle cell disease: trends, benefits, and barriers to adherence in a Ghanaian tertiary hospital

Abstract Objectives To assess the current state, trends, and benefits of hydroxyurea use in sickle cell disease and identify barriers and facilitators to hydroxyurea use in sickle cell disease patients from the perspectives of patients and caregivers. Methods A hospital-based cross-sectional study was carried out at the sickle cell disease clinic, Komfo Anokye Teaching Hospital, Ghana. A semi-structured questionnaire capturing demographics, socio-economic characteristics, medication adherence, and treatment-related factors was randomly administered to 302 participants. Data was analyzed using Chi-square tests, univariate and multivariate analysis, and ordinal logistic regression. Results Two hundred and thirty-seven (78.5%) of the patients had SS genotype, 192 (63.58%) patients were on hydroxyurea at the time of the study. One hundred and nineteen (61.98%) patents were adherent. Decreased number of crises (132, 88.59%) and hospital admissions (78.52%) were some benefits cited by participants. However, high cost of the medication was a major challenge for a significant majority (155, 80.73%). Level of education (P = .019) was found to be significantly associated with level of adherence to hydroxyurea. Conclusion The majority of the patients were on hydroxyurea therapy, with a significant proportion adherent to treatment. Hydroxyurea therapy was associated with a decrease in crises and hospital admissions; however, high cost remained a significant barrier to access and use while perceived benefits of hydroxyurea therapy remained facilitators to hydroxyurea use.