Effect Of Covid-19 Pandemic On Access To Tyrosine Kinase Inhibitors In Nigeria
Keywords:
Nigeria, tyrosine kinase inhibitors (TKIs), COVID-19Abstract
Background: Accessing Tyrosine Kinase Inhibitors (TKIs) during COVID-19 pandemic-related lockdown threatened the abysmally low adherence to therapy in Nigeria. An alternative means of getting medications to the beneficiaries by courier was assessed.
Aims and Objectives: To assess clinic attendance of patients on TKIs during COVID-19 pandemic lockdown in relation to pre-COVID era; the measures taken to ensure safe delivery of TKIs to the door-step of patients on these medications nationwide; and the outcome.
Materials and Methods: Clinic attendance of all active patients with chronic myeloid leukaemia (CML), gastrointestinal stromal tumours (GIST), or chronic eosinophilic leukaemia (CEL) on TKIs was assessed from January to September 2020. In collaboration with the Pharmacy Department, a reliable courier service was engaged to deliver TKIs to the door step of patients with informed consent during the lockdown period. Account of drugs posted and the latest full blood count results of patients were obtained and documented appropriately.
Results: A total of 862 out of 935 registered patients, accessed TKIs during the period of evaluation between March and September 2020; 569 (66%) used courier service, while 220 (25.5%) attended outpatient clinics and 73 (8.5%) were lost to follow up. The majority of the courier users, 219 (38.5%) were from South West (SW), while the least, 30 (5.3%) were from North East (NE). Clinic attendance for April (21) and May (43) during the lockdown was low compared to the average monthly attendance before lockdown (January to March; 174). There was a significant difference in the use of courier service (χ 2 = 34.815; p = 0.001) and clinic attendance (χ2 = 27.000; p = 0.001) when compared with the number of patients registered per region.
Conclusion: The lockdown period impacted very negatively on clinic attendance and the engagement of a courier service facilitated home delivery of TKIs at the peak of COVID-19 pandemic in Nigeria. This method may be further explored to improve adherence to therapy going forward.
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