Impact of Hydroxyurea on Psychological Health of Beta Thalassemia Patients with Moderating Role of Healthcare Professionals’ Performance

Background: Beta –thalassemia (β- thalassemia) has more than 300 different mutations of beta globin gene. The complexity of its physical composition is caused by the imbalance ratio of β-globin which classified into blood transfusion- dependent (TDT) and non-transfusion dependent (NTDT). Modern treatment approaches considered for TDT patients is monthly transfusions to maintain hemoglobin (Hb) levels ranges between 9-10 g/dL. The objectives of this study are to seek out the impact of hydroxyurea (HU) on improving psychological health problems of Quality of Life (QoL), patients’ satisfaction with the use of HU and moderating role of healthcare professionals in satisfying the gap between the use of medicine in managing β- thalassemia disease in a tertiary care hospital. Methods: A cross-sectional, non-probability study and purposive- judgment sampling was conducted after ethical approval. The World Health Organization (WHO) sample size calculator 2.0 was used to recruit TDT patients on HU therapy while visiting the outpatient (OPD) and daycare department of National Institute of Blood Diseases & Bone Marrow Transplantation (NIBD & BMT) hospital in Karachi. A well -structured electronic questionnaire as web form was used for data collection by using Likert scale, with a range of 1-5 and 1-7. The data was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 23.0 and moderation process done by using Process Hayes for SPSS version 3.5.2. Results: We enrolled 290 patients. This study revealed that the impact of HU on improving the psychological health problems of β- thalassemia patients are not evident (r=0.078; p=0.185). Similarly, by inducing moderating role of healthcare professional performance, the impact of HU on psychological health problems were a weak positive non- significant with (r=0.050; p=0.397) correlation observed. Moreover, no significant improvement was observed in psychological health problems of QoL by moderating role of healthcare professional performance (p=0.0835 and 0.6764, respectively). Conclusion: The psychological health problems in β- thalassemia patients are not dependent on HU therapy to have better QoL. In addition, the introduction of healthcare professionals' performance as a moderator does not improve the correlation between HU and psychological domain of QoL.