Side effects and medication adherence of tyrosine kinase inhibitors for patients with chronic myeloid leukemia in Taiwan

Abstract

Nonadherence is common in patients with chronic myeloid leukemia (CML) and leads to treatment failure and poor outcomes. Side effects due to treatment are also common in patients with CML. However, no study has investigated the link between side effects and medication adherence for patients with CML in Taiwan. Therefore, the aim of our study was to explore the influence of side effects on medication adherence in Taiwanese patients with CML.CML in chronic-phase patients treated with breakpoint cluster region-Abelson murine leukemia viral oncogene homolog 1 tyrosine kinase inhibitors were recruited. We designed a questionnaire to collect baseline patient information, medication adherence (measured using the 8-item Morisky Medication Adherence Scale), and side effects. Clinical outcomes were assessed by the 3-month early molecular response rate and the 12-month major molecular response rate. Statistical comparisons of different parameters between adherent and nonadherent groups were conducted.Fifty-eight patients were enrolled in this study, and 31% of them had poor adherence. The lack of information about treatment and medication was the major reason for poor medication adherence. Patients who were younger and unmarried were prone to poor adherence. The occurrence of side effects carried no statistically significant influence on adherence. Poor adherence resulted in a poor treatment response (lower 3-month early molecular response rate and lower 12-month major molecular response rate).Poor adherence is common in Taiwanese patients with CML. The main reason for a decrease in the adherence rate is the lack of comprehensive information about treatment and medication, particularly in young and single population. The next urgent step is to educate patients about their treatment and management of side effects to improve adherence and treatment outcome for patients with CML in Taiwan.

Predictors of tyrosine kinase inhibitor adherence trajectories in patients with newly diagnosed chronic myeloid leukemia

“…26 This could also be a source of selection bias given that younger patients tend to have lower adherence than the general CML population. 27 That said, we found that 26% of our sample fell into one of the non-stable adherent groups, which is consistent with previous studies that found 30% of the general CML population to be nonadherent. [8][9][10] Selection bias may have also been introduced into the sample due to continuous insurance coverage requirements.…”

Sorafenib for Desmoid Tumors. A Cost Analysis: Too Much for Too Little?

“…nausea, vomiting) of long-term TKIs. 25,26 It is not known how long sorafenib side effects would persist or if patients would tolerate long term treatment.…”

Impacts of Pharmacists-Managed Oncology Outpatient Clinic on Resolving Drug-Related Problems in Ambulatory Neoplasm Patients: A Prospective Study in China

“…The main medication therapy management process in this study included the following 5 steps: (1) comprehensive medication therapy review (MTR). After patient’s visit, clinical diseases and medications information of patients, adverse reactions and laboratory tests would be collected and retrieved; (2) identifying drug-related problems (DRPs), to evaluate the indication, efficacy, safety and compliance of patients’ medications [with the 8-item medication adherence scale (Chinese version)] 17 ; (3) developing an intervention plan, and providing treatment advice based on the DRPs identified; (4) making personal medication record (PMR), recording a comprehensive list of patients’ medications; and (5) follow-up ( Figure 1 ).…”