Background Improved survival associated with tyrosine kinase inhibitor (TKI) treatment has transformed chronic myeloid leukaemia (CML) into a long-term disease, but therapeutic success is challenged with poor medicines adherence. Controlling side effects in combination with patient education that includes direct communication between the pharmacist and the patient are essential components for maximising the benefits of TKI treatment.
Purpose To estimate the adherence to oral chemotherapy and describe side effects with TKI treatment and their impact on adherence in patients with CML.
Materials and Methods An 18-month retrospective observational study (from January 2011 to June 2012) was made on patients diagnosed with CML in which patients were selected who collected medicines in the pharmacy and who were being treated with selected TKIs (imatinib, dasatinib, nilotinib).
The SMAQ interview was used to determinate adherence. Adherence data, side effects and demographic characteristics of the patients were tabulated using Excel. The x2 test was used for categorical variables and the t-test was used for normally-distributed continuous variables using SPSS statistical software.
Results 25 patients were included in the study. 16 were men and 9 were women. The mean age was 60 years (25–88). Imatinib was the first line treatment for all patients. The average adherence was 62.5%.
Adherence for patients younger than 50 years was 83.3% and in older patients was 55.6% (P = 0.125). Relating to years of treatment: less than 4 years 70.0% but for longer treatment 57.1% (p = 0.521). Patients with side effects showed less adherence: gastrointestinal disorders (80.0% vs. 64.28%, p = 0.402), musculoskeletal pain (70.0% vs. 42.8% p = 0.188).
Conclusions Data suggest that more than one-third of patients are poorly adherent to TKI treatment. Identifying risk factors such as side effects, and educating patients on the need to take medicines as prescribed is essential to help patients to achieve maximum benefit from their treatment.
No conflict of interest.
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