Background Thalidomide, a potent member of the immunomodulatory drug family, induces both direct myeloma cell death and indirect antimyeloma response through its impact on the microenvironment. The drug is approved in multiple myeloma, and also in other rare diseases, such as severe recurrent aphthous stomatitis. Thalidomide is considered an effective drug in all of its indications; it is also an expensive drug. In an area of limited resources, studies for assessing thalidomide adherence are needed for healthcare professionals and payers alike.
Purpose The purpose of the study was to evaluate adherence to thalidomide.
Material and methods Patients who had at least two successive dispensations of thalidomide, whatever the indication, between 12 July 2015 and 12 July 2016 in our teaching hospital were included in a retrospective study. The medication possession ratio (MPR) was used to evaluate thalidomide adherence. MPR was calculated according to the following formula: MPR=number of days of medication supplied within the refill interval/number of days in refill interval.1 Clinical and dispensation data were obtained from medical and pharmaceutical software in our hospital. Based on the literature, the threshold of 90% was used to define two patient categories: MPR <90%, non-adherent patients; MPR ≥90%, adherent patients.
Results 51 adult patients were included: 40 with multiple myeloma (78%), 6 with cutaneous lupus erythematosus/Jessner–Kanof disease, 4 with serious aphthous/Behcet’s disease and 1 with Miescher’s granuloma. Mean patient age was 63.7±13.9 years; 51% were women. We observed a mean MPR of 0.90±0.16 (range 0.37–1.20). The mean MPR was 0.94±0.13 (range 0.61–1.20) in patients with multiple myeloma and 0.77±0.21 (range 0.37–0.99) in patients with other diseases. A total of 61% of patients were considered as adherents. The percentage of adherent patients was significantly higher in patients with multiple myeloma than in patients with other diseases (70% vs 27%, respectively; p=0.015).
Conclusion Data are lacking concerning thalidomide adherence. Optimising thalidomide adherence may increase the efficacy of thalidomide based regimens. Considering the high cost of thalidomide, efforts to increase thalidomide adherence may also reduce wasted money in dispensing pills that are not taken by patients.
References and/or acknowledgements 1. Peterson AM, et al. A checklist for medication compliance and persistence studies using retrospective databases. Value Health2007;10:3–12.
No conflict of interest
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