Adherence and future discontinuation of tyrosine kinase inhibitors in chronic phase chronic myeloid leukemia. A patient-based survey on 1133 patients.
Therapeutic approach for chronic myeloid leukemia (CML) patients has undergone a revolutionary change with the introduction of tyrosine kinase inhibitors, which improved overall survival and quality of life. Optimal therapy adherence has become of paramount importance to maximize the benefits in the long-term outcome. Several evidences have been reported that personal factors, such as social support, psychological and subjective perceptions about the drug used and the future, could influence adherence. We here report the results of a questionnaire specifically designed to evaluate factors influencing adherence and perceptions about the future, distributed to patients during regional Italian meetings. Overall, 1133 patients compiled the questionnaire: median age was 57 years. High rate of adherence was reported, but 42% of interviewed patients admitted that they had occasionally postponed a dose and 58% had discontinued therapy mainly for forgetfulness. The majority of patients discussed with personal physician about the importance of adherence and received sufficient information about illness and treatment, but would like to have discussed more about discomfort, anxiety and fear of the future. Summarizing personal drug compliance and estimating how many days a month, on average, the patients did not take the drug, the majority answered that it was less than 3 days (55%) and only a minority (4%) admitted that it was more than 7 days. Interviewed about discontinuation, 49% of patients answered that wouldn't interrupt because of fear of losing all the results achieved so far. This study suggests a higher level of satisfaction with more information received but the need of improving communication about possible future treatment free remission.
Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy. Electronic address: breccia@bce.uniroma1.it.
Massimo
M
Breccia
Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy.
Fabio
F
Efficace
Hematology, Cattolica University, Rome, Italy.
Simona
S
Sica
Hematology, S. Eugenio Hospital, Rome, Italy.
Elisabetta
E
Abruzzese
S. Giovanni Hospital, Rome, Italy.
Michele
M
Cedrone
Hospital Cervello, Palermo, Italy.
Diamante
D
Turri
San Martino Hospital, Genoa, Italy.
Marco
M
Gobbi
Hematology Unit, IRCCS AOU San Martino-IST, Genoa, Italy.
Angelo Michele
AM
Carella
Careggi Hospital, Florence, Italy.
Antonella
A
Gozzini
Hematology and Bone Marrow Transplant Unit, Businco Hopsital, Cagliari, Italy.
Emilio
E
Usala
Ferrara University, Ferrara, Italy.
Francesco
F
Cavazzini
Department of Oncology Hematology, ASL Salerno, Sapri, Italy.
Paolo
P
Danise
Udine University, Udine, Italy.
Mario
M
Tiribelli
Padua University, Padova, Italy.
Gianni
G
Binotto
S. Giovanni Battista Hospital, Turin, Italy.
Patrizia
P
Pregno
Siena University, Siena, Italy.
Monica
M
Bocchia
Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
Gianluca
G
Gaidano
Parma University, Parma, Italy.
Monica
M
Crugnola
Verona University, Verona, Italy.
Massimiliano
M
Bonifacio
Modena University, Modena, Italy.
Paolo
P
Avanzini
Belcolle Hospital, Viterbo, Italy.
Francesca
F
Celesti
Trento Hospital, Trento, Italy.
Anna
A
Guella
Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy.
Bruno
B
Martino
Cardarelli Hospital, Naples, Italy.
Mario
M
Annunziata
Federico II University, Naples, Italy.
Luigiana
L
Luciano
Ferrarotto Hospital, Catania University, Catania, Italy.
Fabio
F
Stagno
Haematology Unit and Bone Marrow Transplant Centre, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
Daniele
D
Vallisa
Niguarda Hospital, Milan, Italy.
Esther
E
Pungolino
IRCSS Cà Granda Policlinico, Milan, Italy.
Alessandra
A
Iurlo
Hematology and Bone Marrow Transplant Units, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
Alessandro
A
Rambaldi
Brescia University, Brescia, Italy.
Ida
I
Nardiello
S. Matteo Hospital, Pavia, Italy.
Esther
E
Orlandi
Department of Health Sciences, University of Milano-Bicocca, Monza, Italy.
Carlo
C
Gambacorti-Passerini
Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy.
Giuliana
G
Alimena
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015466:Leukemia, Myeloid, Chronic-Phase / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011788:Quality of Life; D011795:Surveys and Questionnaires; D055815:Young Adult; D016903:Drug Monitoring
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
Adherence; Chronic myeloid leukemia; Survey