Background Adherence to tyrosine-kinase inhibitors (TKIs) treatment is regarded as one of the mainstays of chronic myeloid leukaemia (CML).
Purpose To analyse the variability in the adherence to TKIs treatment of CML in the function of the prescribed drug and evaluate how pharmaceutical care can improve it.
Material and methods A prospective, multicentre and observational study from October 2014 to May 2015. Participants were patients diagnosed with CML who received treatment with TKIs.
The study consists of two phases: observation phase to obtain initial vision of the adherence; and a second phase of intervention after 12 months, where pharmaceutical care was performed on non-adherent patients, and re-evaluation of adherence was carried out.
Adherence was analysed by compilation of three indirect methods: MMAS8 self-questionnaire (8-item Morisky Medication-Adherence scale); the Simplified Scale for Adherence Problems (ESPA); and the dispensing record (DR) in the past 6 month (non-adherent: DR lower than 90%). The identification of a lack in adherence by any of the three methods, classified the patient as non-adherent.
The study had been approved by the hospital’s Ethical Committee (CEIC) and classified as EPA-SP by the Spanish Agency for Drugs and Health Products (AEMPS) with the LOH-IMA-2013–01 code. Patients were requested to sign an informed consent form prior to their inclusion.
Results One hundred and thirty patients were included, with an average age of 58.9 (20–90) years and 55.5% males. 63.8% of patients received treatment with imatinib, 24.6% nilotinib and 11.6% with dasatinib.
Adherence in the observation phase was 68.4%, showing no differences in the adherence of the different treatments (p=0.67). After the intervention phase, the adherence was 82.9% (p=0.007).
However, treatment subgroup analysis showed that adherence, after the intervention phase, only improved in those patients whose TKI was given once daily: imatinib 54.8% vs 81.9% (p=0.002); nilotinib 63.6% vs 78.5% (p=0,156) and dasatinib 54.3% vs 86.7% (p=0.049).
Conclusion Our results suggest that pharmacist intervention in outpatient units improve adherence in patients with CML treated with TKIs. However, the adherence is only improved with the once-daily treatments of imatinib and dasatinib.
No conflict of interest
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