Impact of tailored patient education on adherence of patients with chronic myeloid leukaemia to tyrosine kinase inhibitors: a randomized multicentre intervention study.
OBJECTIVE
The aim of this study was to evaluate the influence of tailored patient education on adherence to tyrosine kinase inhibitor medication among patients with chronic myeloid leukaemia.


BACKGROUND
Management of chronic myeloid leukaemia has changed dramatically during the last decade. While medication adherence is crucial to clinical response, little is known about how to improve patients' adherence.


METHODS
Randomized multicentre intervention study.


METHODS
The study was conducted between June 2012-August 2014. Eighty-six patients with chronic myeloid leukaemia who had been on tyrosine kinase inhibitor medication for at least six months from eight hospitals were randomized into intervention and control groups. Intervention combined nurse-conducted medication counselling, an information booklet, video and website and text message reminders. Patients were interviewed to assess medication adherence using Morisky's 8-Item Medication Adherence Scale at baseline and nine months.


RESULTS
Medication adherence improved with the adherence aids used. At nine months, 51% of patients were highly adherent in the intervention group, compared with 21% in the control group. Adherence improved for a higher proportion of patients in the intervention group than the control group (49% vs. 18%). Morisky's score decreased in almost half of control group cases. Patients were most satisfied with face-to-face counselling (86%) and the information booklet (83%) and least satisfied with text messages (9%).


CONCLUSIONS
Tailored patient education improved the medication adherence of patients with chronic myeloid leukaemia. Without this, adherence behaviour tended to decline. Personal communication with a nurse proved to be an essential part of adherence support and should not be ignored.
Division of Pharmacology and Pharmacotherapy, University of Helsinki, Finland.
Meri
M
Kekäle
Department of Orthopedics and Traumatology, Helsinki University Central Hospital and University of Helsinki, Finland.
Tim
T
Söderlund
Department of Medicine, Helsinki University Central Hospital and University of Helsinki, Finland.
Perttu
P
Koskenvesa
Medical Center Mehiläinen, Nummela, Finland.
Kimmo
K
Talvensaari
Division of Pharmacology and Pharmacotherapy, University of Helsinki, Finland.
Marja
M
Airaksinen
D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000627:therapeutic use; D020407:Internet; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D010353:Patient Education as Topic; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D017010:Reminder Systems; D060145:Text Messaging
D007074:Immunoglobulin G; C051713:antineoplastic agent K 18; D011505:Protein-Tyrosine Kinases; D008558:Melphalan
adherence aids; chronic myeloid leukaemia; medication adherence; nurse education; nursing; patient education; tyrosine kinase inhibitors