Adherence and Coping Strategies in Outpatients With Chronic Myeloid Leukemia Receiving Oral Tyrosine Kinase Inhibitors

Hefner, Jochen; Csef, Eva-Johanna; Kunzmann, Volker

doi:10.1188/17.onf.e232-e240

Cited by 5 publications

(3 citation statements)

References 69 publications

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“…A total of 2 patients resided with a spouse or family but perceived no outside support or assistance for their medication adherence. Finally, spirituality was mentioned by 3 patients as playing an important role in their adherence to OAC, which appears to have been a focus in only 1 prior publication among cancer patients [29].…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators of Using Sensored Medication Adherence Devices in a Diverse Sample of Patients With Multiple Myeloma: Qualitative Study

Asfaw¹,

Yan²,

Sweiss³

et al. 2018

JMIR Cancer

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BackgroundMany recently approved medications to manage multiple myeloma (MM) are oral, require supportive medications to prevent adverse effects, and are taken under complex schedules. Medication adherence is a concern; however, little attention has been directed toward understanding adherence in MM or associated barriers and facilitators. Advanced sensored medication devices (SMDs) offer opportunities to intervene; however, acceptability among patients with MM, particularly African American patients, is untested.ObjectiveThis study aimed to explore patients’ (1) perceptions of their health before MM including experiences with chronic medications, (2) perceptions of adherence barriers and facilitators, and (3) attitudes toward using SMDs.MethodsAn in-person, semistructured, qualitative interview was conducted with a convenience sample of patients being treated for MM. Patients were recruited from within an urban, minority-serving, academic medical center that had an established cancer center. A standardized interview guide included questions targeting medication use, attitudes, adherence, barriers, and facilitators. Demographics included the use of cell phone technology. Patients were shown 2 different pill bottles with sensor technology—Medication Event Monitoring System and the SMRxT bottle. After receiving information on the transmission ability of the bottles, patients were asked to discuss their reactions and concerns with the idea of using such a device. Medical records were reviewed to capture information on medication and diagnoses. The interviews were audio-recorded and transcribed. Interviews were independently coded by 2 members of the team with a third member providing guidance.ResultsA total of 20 patients with a mean age of 56 years (median=59 years; range=29-71 years) participated in this study and 80% (16/20) were African American. In addition, 18 (90%, 18/20) owned a smartphone and 85% (17/20) were comfortable using the internet, text messaging, and cell phone apps. The average number of medications reported per patient was 13 medications (median=10; range=3-24). Moreover, 14 (70%, 14/20) patients reported missed doses for a range of reasons such as fatigue, feeling ill, a busy schedule, forgetting, or side effects. Interest in using an SMD ranged from great interest to complete lack of interest. Examples of concerns related to the SMDs included privacy issues, potential added cost, and the size of the bottle (ie, too large). Despite the concerns, 60% (12/20) of the patients expressed interest in trying a bottle in the future.ConclusionsResults identified numerous patient-reported barriers and facilitators to missed doses of oral anticancer therapy. Many appear to be potentially mutable if uncovered and addressed. SMDs may allow for capture of these data. Although patients expressed concerns with SMDs, most remained willing to use one. A feasibility trial with SMDs is planned.

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Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators of Using Sensored Medication Adherence Devices in a Diverse Sample of Patients With Multiple Myeloma: Qualitative Study

Asfaw¹,

Yan²,

Sweiss³

et al. 2018

JMIR Cancer

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“…As expected, adherence to prescribed TKI treatment schedules signifcantly impacts the treatment response [17][18][19][20], which is monitored by measuring "the level of copies of the faulty BCR-ABL gene in the blood," and is considered a strong survival predictor [3]. However, while estimates of adherence vary (often due to the complexity of measuring this behaviour), it has been found to be as low as 51% [21]. Poorer adherence in CML can relate to worse quality of life and has been associated with increased symptom burden [22] and adverse drug reactions [23].…”

Section: Introductionmentioning

confidence: 92%

Chronic Myeloid Leukaemia: A Qualitative Study of Patient and Practitioner Experiences of Managing Treatment

Hewison,

Roman,

Smith

et al. 2023

European Journal of Cancer Care

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Background. Following the dramatic impact of tyrosine kinase inhibitor (TKI) drugs on chronic myeloid leukaemia (CML) survival, research interest has grown into the long-term impact of treatment, identifying difficulties with medication adherence and ongoing side effects. Qualitative studies suggest the disease has a significant physical and psychological impact on patients, and medication management may be complex. However, only one study worldwide has examined healthcare practitioner (HCP) experiences of managing CML treatment and very little UK qualitative research exists exploring the patient experience. Purpose. Our qualitative study aimed to investigate both patient and HCP experiences of managing CML treatment in the UK. Methods. Patients and HCPs were purposively sampled from within the Haematological Malignancy Research Network (HMRN), a UK population-based patient cohort. Qualitative interviews were carried out with seventeen patients and thirteen HCPs, and data were analysed using thematic analysis. Results. Four themes were developed from interview analysis: “Importance of optimal clinical management,” “Multiple adherence strategies,” “Inconsistent management of adherence,” and “Controlling side effects is complex.” HCPs tended to focus on sometimes complex, clinical decision-making. Patients described various strategies to support adherence and manage side effects, some of which HCPs seemed to be less aware of. Several patients did not discuss non-adherence or side effects with their HCP, who tended to avoid direct enquiry regarding adherence and could be uncertain about adherence advice, whilst relying on medical strategies to manage side effects. Conclusions. Despite HCPs focusing on the medical management of CML treatment, patients may opt to use self-management techniques to control adherence and side effects and can be reluctant to discuss related difficulties. Increased clinic time and clear adherence advice guidance may support such discussion, in addition to adjusting the context of follow-up care through the introduction of shared care with GP services.

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“…A pesar de la importancia de la evaluación cognitiva como variable reguladora de la adherencia terapéutica, gran parte de las investigaciones sobre la relación del estrés con los padecimientos crónicos se han centrado en la descripción de las estrategias de afrontamiento (Gutiérrez y Lemos, 2016;Hefner, Csef y Kunzmann, 2017) y la relación que tienen con variables tales como el estado de salud y la eficacia del tratamiento médico (Andrés, Torrico y Remesal, 2012), la adherencia terapéutica y la depresión (Bright y Stanton, 2017), la calidad de vida y las emociones negativas (Gaviria et al, 2007;Hulber-Williams et al, 2012). Una consecuencia de lo anterior es que instrumentos como la Brief COPE (Aguado et al, 2013;Bright y Stanton;Carver, 1997;Langford et al, 2017), el Ways of Coping (Folkman y Lazarus, 1985;), la Escala de Modos de Afrontamiento (Andrés et al, 2012), el Emotional Approach Coping (Bright y Stanton, 2017), el Cuestionario de Afrontamiento del Estrés (Gaviria et al, 2007) y el Cuestionario de Estrés, Emociones y Afrontamiento (Vega, Muñoz, Berra, Nava y Gómez, 2012) le den preponderancia en la medición del afrontamiento, dejando de lado la medición del concepto de evaluación cognitiva.…”

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Escala de Evaluación Cognitiva y Estrés: análisis de sus propiedades psicométricas con pacientes oncológicos

2022

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El modelo transaccional de estrés se ha utilizado para estudiar el comportamiento de pacientes oncológicos a lo largo del diagnóstico y el tratamiento médico. La variabilidad en el comportamiento de los pacientes y sus repercusiones en la adherencia terapéutica pueden ser examinadas con base en la evaluación cognitiva de la situación y en sus recursos para afrontar las demandas del entorno. El objetivo de este trabajo se centró en la construcción de la Escala de Evaluación Cognitiva y Estrés y en el análisis de su validez y confiabilidad, para lo cual se llevó a cabo un estudio transversal en una muestra de 200 pacientes atendidos en el servicio de oncología del Hospital Juárez de México. Se efectuó un análisis factorial exploratorio y un análisis de consistencia interna. Los resultados muestran que la escala se conforma de 30 ítems con dos factores, uno con 13 ítems, Evaluación Primaria, y el otro, Evaluación Secundaria, con 17 ítems. Se concluye que dicha escala es una herramienta de medida que muestra propiedades adecuadas en cuanto a su confiabilidad y validez, y que mantiene coherencia teórica con el modelo transaccional de estrés.

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Adherence and Coping Strategies in Outpatients With Chronic Myeloid Leukemia Receiving Oral Tyrosine Kinase Inhibitors

Cited by 5 publications

References 69 publications

Barriers and Facilitators of Using Sensored Medication Adherence Devices in a Diverse Sample of Patients With Multiple Myeloma: Qualitative Study

Barriers and Facilitators of Using Sensored Medication Adherence Devices in a Diverse Sample of Patients With Multiple Myeloma: Qualitative Study

Chronic Myeloid Leukaemia: A Qualitative Study of Patient and Practitioner Experiences of Managing Treatment

Escala de Evaluación Cognitiva y Estrés: análisis de sus propiedades psicométricas con pacientes oncológicos

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