Background

Beta‐thalassemia major (β‐TM) is a severe hereditary blood disorder, common in Palestine due to high consanguinity rates. Lifelong iron chelation therapy (ICT) is vital for managing iron overload from regular transfusions, but adherence remains a major challenge.

Objective

This study investigates factors influencing ICT adherence among β‐TM patients in Palestine, focusing on sociodemographic, clinical, psychological, and healthcare‐related aspects.

Methods

A cross‐sectional study was conducted at the National Thalassemia Center, Nablus, from July 2024 to the end of October 2024, including 120 β‐TM patients aged 3–33. Data were collected through structured interviews using a validated questionnaire covering demographics, disease knowledge, adherence, and satisfaction with healthcare. Adherence was based on missed doses and ferritin levels, analyzed using SPSS V21.0.

Results

62.5% of patients were adherent, with ferritin levels ≤ 2500, while nonadherent patients had levels ≥ 2501 (p < 0.001). Although 98.7% of adherent and 100% of nonadherent patients had good disease knowledge, it did not predict adherence. Barriers included psychological distress (21.7%), medication side effects (16.7%), and inconsistent medication supply. Satisfaction with healthcare staff (p < 0.001) and socioeconomic status, particularly income (p = 0.014), significantly affected adherence.

Conclusion

Adherence is influenced more by psychological, economic, and healthcare service factors than knowledge. A multidisciplinary approach—providing psychological support, stable medication access, and stronger patient–provider relationships—is essential to improve adherence and outcomes for β‐TM patients in Palestine.

Title

Anemia

Publisher

Wiley

Publisher Country

United States of America

Publication Type

Online only

Volume

2025

Year

2025

Pages

649477:17 pages