The medication usage pattern and prevalence of polypharmacy among patients with sickle cell disease: a population-based study in southern Iran

ABSTRACT

Background

Due to the numerous complications associated with sickle cell disease (SCD), patients often receive a variety of medications alongside their SCD treatment. However, a notable gap exists in the current literature regarding medication use patterns among them. This study aimed to investigate medication usage patterns in patients with SCD.

Research design and methods

This cross-sectional study, conducted in Bushehr province, employed a stratified random sampling method to select eligible participants with SCD. A thorough interview gathered various information, including details about the medications. The Anatomical Therapeutic Chemical classification system was utilized for drug classification. Polypharmacy was defined as the concurrent use of at least five medications.

Results

A total of 300 individuals with SCD were included in this study. Polypharmacy was observed in 26.3% (95% CI: 20.8%-32.8%) of the study population. The analyses revealed positive associations between the use of more concurrent medication use and higher age groups and having multimorbidity. Antianemic preparations (86.7%), antineoplastic agents (58.3%), and vitamins (41.0%) were the most frequent medication classes used by the study participants.

Conclusions

Our study revealed notable underutilization of hydroxyurea and a high rate of polypharmacy, associated with age and multimorbidity, among patients with SCD in southern Iran.

KEYWORDS:

• Sickle cell disease
• polypharmacy
• drug therapy
• pharmaceutical preparations
• Iran

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Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

A Amini, Erfan Taherifard, J Hassanzadeh, and HM Vardanjani contributed to the conceptualization and design of this study. A Amini, MR Rajabi, F Zamani, SJ Rekabpour, and R Jafaraghaie conducted the data collection and interviews. E Taherifard, M Akbari, E Taherifard, and ND Ebrahimi were involved in the data cleaning and statistical analyses. Results interpretation was performed by SJ Rekabpour, J Hassanzadeh, and HM Vardanjani. M Akbari, E Taherifard, ND Ebrahimi, MR Rajabi, F Zamani, and R Jafaraghaie contributed to the manuscript’s drafting. Erfan Taherifard, J Hassanzadeh, and HM Vardanjani participated in revising the draft. All authors have read and approved the final manuscript.

Acknowledgments

We express our sincere gratitude to Dr. Ravanbod and the Shafa clinic staff for their invaluable assistance in preparing the sampling frame for patients with SCD.

Additional information

Funding

This paper was funded by the Shiraz University of Medical Sciences (Project No. 25622).