Background Thalidomide, lenalidomide and pomalidomide belong to the immunomodulatory drug family (IMIDs). Data on IMID adherence are lacking.
Purpose The purpose of the study was to evaluate adherence to IMIDs in patients with multiple myeloma.
Material and methods All patients managed in our teaching hospital for a multiple myeloma who had at least two successive dispensations of IMIDs were included in a prospective study between 1 March 2016 and 15 May 2016. We used a cancer specific questionnaire to measure patient adherence to IMIDs1 (10 questions; 10 points). Non-adherence was defined as a score <8 points. The medication possession ratio (MPR) was also calculated to evaluate IMID adherence: MPR=number of days of medication supplied within the refill interval/number of days in refill interval. The threshold of 90% was used to define two patient categories: MPR < 90%, non-adherent patients; MPR ≥90% adherent patients.1 Clinical and dispensation data were obtained from medical and pharmaceutical software in our hospital.
Results 63 adult patients were included. Mean patient age was 68.2±10.4 years; 67% were men. Patients received lenalidomide (54%), pomalidomide (25%) or thalidomide (21%). Median time since diagnosis was 2.8 years (range 0.2–17.1). More than half of the patients used tools to help them with their medication. The mean questionnaire score was 8.2±1.2 (range 4–10). Mean time to fulfil the questionnaire was 9.2±4.7 min. 41% of the patients had ever taken their medicine too late in comparison with usual time. 57% of patients thought they took too many medicines. 43% of patients did not know the name of their medicines. We observed a mean MPR of 0.95±0.10 (range 0.67–1.20). A total of 76% of patients were considered as adherent using the questionnaire and 72% using the MPR.
Conclusion Adherence to IMIDs was not optimal in our population. The use of adherence questionnaire and/or MPR may help the pharmacist to detect non-adherent patients. In these patients, pharmaceutical interventions may be of major interest.
References and/or acknowledgements 1. Daouphars M, Ouvry M, Lenain P, et al. Preliminary validation of self-assessment tool to measure imatinib adherence in patients with chronic myeloid leukaemia. Pharmacotherapy2013;33:152–6.
No conflict of interest
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