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Dahlui M, Hishamshah MI, Rahman AJA, Aljunid SM
Correspondence: Dr Maznah Dahlui, maznahd@email@example.com
Introduction The quality of life of transfusion-dependent thalassaemia patients is affected by the disease itself and iron overload complications from repeated blood transfusion. Desferrioxamine has been used to remove the excess iron, resulting in decreased mortality and morbidity. In Malaysia, a significant proportion of the transfusion-dependent thalassaemia patients are not prescribed desferrioxamine, due to its high cost, especially as it is not subsidised by the government. The aim of this study was to measure the quality of life of thalassaemia patients on desferrioxamine treatment.
Methods A cross-sectional study was performed on all transfusion-dependent thalassaemia patients on follow-up at two tertiary hospitals in Kuala Lumpur, Malaysia, in 2005. Quality-of-life scores were measured by using the translated MOS SF-36 questionnaires, while diseases related to iron overload complications were obtained from the medical records. Use of desferrioxamine was elicited through interviews and validated by drug records. Quality-adjusted life-years (QALYs) presented were formulated from residual life-years and quality-of-life scores.
Results A total of 112 transfusion-dependent thalassaemia patients were recruited, with 54 (48 percent) and 58 (52 percent) patients on sub-optimum and optimum desferrioxamine treatments, respectively. QALYs were higher in patients on optimum desferrioxamine (9.04, standard deviation [SD] 2.46) than patients on sub-optimum desferrioxamine (5.12, SD 2.51). QALYs were associated with the level of serum ferritin, iron overload complications and total family income.
Conclusion Optimum desferrioxamine usage reduces iron overload complications and provides a better quality of life.
Keywords: desferrioxamine treatment, iron overload complications, quality of life, quality-adjusted life-years, transfusion-dependent thalassaemia
Singapore Med J 2009; 50(8): 794-799