Simon Wu1, Desmond Chee1, Anna Ugalde1, Phyllis Butow2, John Seymour3, Penelope Schofield1. 1. Department of Cancer Experiences Research, Peter MacCallum Cancer Center, East Melbourne, Victoria,Australia. 2. Department of Psychology,The University of Sydney,Sydney, New South Wales,Australia. 3. Faculty of Medicine, Dentistry and Health Sciences,The University of Melbourne,Parkville, Victoria,Australia.
Abstract
OBJECTIVE: Consistent use of imatinib is critical for treatment success in chronic myeloid leukemia, yet perfect adherence to the prescribed clinical regimen is reported to be as low as 14%. This study aimed to understand patients' experiences of chronic myeloid leukemia with a qualitative approach, including identified facilitators and barriers to adherence, drawing on patients' and health professionals' perspectives, recording comments made by patients and health professionals involved with the same treatment team. METHOD: We recruited patients with chronic myeloid leukemia prescribed imatinib therapy and health professionals involved in their treatment from a specialized cancer center. Semi-structured qualitative interviews were recorded, transcribed, and manually analyzed using interpretive phenomenological analysis. Recruitment ceased upon saturation, with 16 patients and 10 health professionals (hematologists n = 4, nurses n = 3, pharmacists n = 3). RESULTS: Twelve patients reported at least one instance of nonadherence. Reasons for unintentional nonadherence included forgetfulness related to variations of routine and doctor-patient communication issues. Reasons for intentional nonadherence included desires to reduce dose-dependent side effects and insufficient support. Patients who reported higher nonadherence rates felt complacent following periods of sustained disease control or had received conflicting advice regarding nonadherence. Health professionals had difficulty in accurately evaluating medication adherence due to a lack of reliable measures, utilizing patient self-report and manifestations of suboptimal disease control to guide assessments. SIGNIFICANCE OF RESULTS: Adherence issues persist throughout the course of treatment. While high patient-reported nonadherence rates were recorded, health professionals were often unaware of the complex causes, compounded by an inadequacy of adherence assessment tools. Some patients reported nonadherence events because of insufficient education or lack of access to prompt medical guidance. These issues should be addressed to improve clinical practice.
OBJECTIVE: Consistent use of imatinib is critical for treatment success in chronic myeloid leukemia, yet perfect adherence to the prescribed clinical regimen is reported to be as low as 14%. This study aimed to understand patients' experiences of chronic myeloid leukemia with a qualitative approach, including identified facilitators and barriers to adherence, drawing on patients' and health professionals' perspectives, recording comments made by patients and health professionals involved with the same treatment team. METHOD: We recruited patients with chronic myeloid leukemia prescribed imatinib therapy and health professionals involved in their treatment from a specialized cancer center. Semi-structured qualitative interviews were recorded, transcribed, and manually analyzed using interpretive phenomenological analysis. Recruitment ceased upon saturation, with 16 patients and 10 health professionals (hematologists n = 4, nurses n = 3, pharmacists n = 3). RESULTS: Twelve patients reported at least one instance of nonadherence. Reasons for unintentional nonadherence included forgetfulness related to variations of routine and doctor-patient communication issues. Reasons for intentional nonadherence included desires to reduce dose-dependent side effects and insufficient support. Patients who reported higher nonadherence rates felt complacent following periods of sustained disease control or had received conflicting advice regarding nonadherence. Health professionals had difficulty in accurately evaluating medication adherence due to a lack of reliable measures, utilizing patient self-report and manifestations of suboptimal disease control to guide assessments. SIGNIFICANCE OF RESULTS: Adherence issues persist throughout the course of treatment. While high patient-reported nonadherence rates were recorded, health professionals were often unaware of the complex causes, compounded by an inadequacy of adherence assessment tools. Some patients reported nonadherence events because of insufficient education or lack of access to prompt medical guidance. These issues should be addressed to improve clinical practice.
Authors: David Sanford; Rachel Kyle; Alejandro Lazo-Langner; Anargyros Xenocostas; Ian Chin-Yee; Kang Howson-Jan; Cyrus C Hsia Journal: Curr Oncol Date: 2014-12 Impact factor: 3.677
Authors: Lucas M Okumura; Valquíria D Antunes; Karina S Aguiar; Tatiane Farias; Vânia M Andrzejevski; Vaneuza M Funke Journal: Pharm Pract (Granada) Date: 2015-06-15
Authors: Amparo Talens; Mercedes Guilabert; Blanca Lumbreras; María Teresa Aznar; Elsa López-Pintor Journal: Int J Environ Res Public Health Date: 2021-04-17 Impact factor: 3.390
Authors: Amanda Pereira-Salgado; Jennifer A Westwood; Lahiru Russell; Anna Ugalde; Bronwen Ortlepp; John F Seymour; Phyllis Butow; Lawrence Cavedon; Kevin Ong; Sanchia Aranda; Sibilah Breen; Suzanne Kirsa; Andrew Dunlevie; Penelope Schofield Journal: JMIR Mhealth Uhealth Date: 2017-12-06 Impact factor: 4.773