Investigating factors associated with adherence behaviour in patients with chronic myeloid leukemia: an observational patient-centered outcome study

Abstract

Background:Optimal adherence to imatinib therapy is of paramount importance to maximise treatment effectiveness in patients with chronic myeloid leukaemia (CML). The main objective of this study was to investigate patient-reported personal factors associated with adherence behaviour.Methods:Analysis was conducted on 413 CML patients receiving long-term therapy with imatinib. Adherence behaviour was measured with the Morisky Medication Adherence Scale and personal factors investigated included: quality of life, perceived social support, fatigue, symptom burden, psychological wellbeing and desire for additional information. Key socio-demographic and treatment-related factors were also taken into account. Univariate and multivariate logistic regression analyses were used to investigate factors associated with optimal adherence to therapy.Results:In all, 53% of patients reported an optimal adherence behaviour. The final multivariate model retained the following variables as independent predictors of optimal adherence to therapy: desire for more information (ref. no), odds ratio (OR)=0.43 (95% confidence interval (CI), 0.29–0.66; P<0.001), social support (higher score representing greater support), OR=1.29 (95% CI, 1.11–1.49; P<0.001) and concomitant drug burden (ref. no), OR=1.82 (95% CI, 1.18–2.80; P=0.006).Conclusion:This study suggests that a higher level of social support, satisfaction with information received and concomitant drug burden are the main factors associated with greater adherence to long-term imatinib therapy.

Adherence and future discontinuation of tyrosine kinase inhibitors in chronic phase chronic myeloid leukemia. A patient-based survey on 1133 patients

“…Our results reinforced those observed as results of the interviews conducted by the Hammersmith group as well as by other groups [6,10,12]. Side effects associated to poor adherence can be managed by prompt attention and supportive care.…”

“…Therefore, as in the CML arena very few studies addressed this issue in the real-world setting [10,11] we have performed a large patient-based survey to investigate adherence behaviors and potential relationships with QoL, treatment satisfaction, and social life. Also, we focused on patient's attitude toward the possibility of drug discontinuation in future treatment free programs.…”

Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries

“…Also there might be a correlation with the number of medications patients have to take per day. The effect of more medications that have to be taken influencing adherence positively has also already been described by Efficace et al (2012). Patients who have to take medications with an instant response to non-adherence might be more adherent to their CML medication as well, because they take it together with the other medication.…”

“…The general importance of a good doctor-patient relationship has been described often in adherence research and cannot be emphasized enough especially in chronic diseases (Efficace et al 2012;Vermeire et al 2001). Generally, it is important for physicians to understand the impact they may be having on adherence, and to be involved in promoting better adherence in their CML patients.…”

“…In an Italian study, Efficace et al (2012) found 53% of 413 patients with optimal adherence behaviour and identified social support and concomitant medication as primary drivers for adherence while lack of information was influencing adherence negatively.…”