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Good adherence to imatinib therapy among patients with chronic myeloid leukemia--a single-center observational study
Sofia Jönsson1, Bob Olsson2, Jenny Söderberg3
1Section of Hematology, Department of Internal Medicine, Sahlgrenska University Hospital, SE-413 45, Gothenburg, Sweden. sofia.jonsson@vgregion.se.
Insights
Adherence to imatinib therapy in chronic myeloid leukemia (CML) patients is often challenging. This study found good adherence rates, highlighting the importance of patient information and consistent care from a single hematologist.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Imatinib therapy is a cornerstone treatment for chronic myeloid leukemia (CML).
- Previous research indicated potential obstacles to patient adherence with imatinib treatment.
- Understanding adherence factors is crucial for optimizing CML management.
Purpose of the Study:
- To evaluate adherence to imatinib therapy in CML patients at Sahlgrenska University Hospital.
- To identify factors influencing imatinib adherence in this patient cohort.
Main Methods:
- A cohort of CML patients treated with imatinib was identified.
- Adherence was assessed using the nine-item Morisky Medication Adherence Scale (MMAS).
- Structured interviews were conducted to explore factors affecting adherence.
Main Results:
- A high adherence rate was observed, with a mean MMAS score of 12.3 (range, 9-13).
- Key predictors of adherence included being well-informed and having consistent contact with a single hematologist.
- Easy clinic access and patient involvement in treatment decisions also correlated with good adherence.
Conclusions:
- Contrary to previous findings, CML patients can demonstrate very good adherence to imatinib.
- Enhanced patient information and continuity of care are suggested strategies to improve imatinib adherence.
- Optimizing adherence can lead to better long-term outcomes for CML patients.
Abstract:
Previous studies have suggested that adherence to imatinib therapy can be an obstacle among patients with chronic myeloid leukemia (CML). We studied adherence to imatinib therapy among CML patients treated at the Sahlgrenska University Hospital. We identified all CML patients that were alive at the 1st of January 2010 (n = 70). Nineteen patients were excluded due to a history of allogenic hematopoietic stem cell transplantation, and nine were excluded due to treatment with other tyrosine kinase inhibitors. Thirty-eight out of 42 patients (90%) treated with imatinib accepted inclusion in the study. The patients were interviewed in a structured way, and adherence was evaluated in a standardized way using the nine-item Morisky Medication Adherence Scale that ranges from 1 to 13. A Morisky score ≤10 indicates nonadherence and ≥11 indicates adherence. In addition, predefined follow-up questions were asked to identify factors known to influence adherence to therapy. In contrast to previous studies, our patients showed good adherence to imatinib therapy with a mean Morisky score of 12.3 out of 13 (range, 9-13). The interviews revealed factors known to predict adherence to therapy, namely being well informed and having frequent contact with a single hematologist. Furthermore, the patients had easy access to the treating clinic and felt that they took part in decisions concerning their disease and treatment. We show that adherence to imatinib can be very good in CML patients, and we suggest that simple measures such as increased patient information and continuity of care will increase adherence in patients with CML.
