Patient adherence to tyrosine kinase inhibitor therapy in chronic myeloid leukemia: influence of coping strategies and psychological factors
DOI:
https://doi.org/10.22122/cdj.v8i3.526Keywords:
Adherence, Chronic Myeloid Leukemia, Coping Strategies, Anxiety, DepressionAbstract
BACKGROUND: Medication non-adherence is associated with poor health outcomes and increased healthcare costs. Although the use of tyrosine kinase inhibitor (TKI) for chronic myeloid leukemia (CML) treatment is satisfactory in clinical results, it is subject to non-adherence. In this study, we intend to verify if there are psychological factors, such as anxiety, depression, and coping style that can influence medication adherence.
METHODS: The study was conducted on 120 patients with CML receiving long-term TKI therapy. The sample was collected in the years 2016-2017 at Department of Oncology-Hematology in Pescara, Italy. Adherence behaviour was measured with the eight-item Morisky Medication Adherence Scale (MMAS-8) and psychological factors investigated included: anxiety and depression symptoms [Hospital Anxiety and Depression Scale (HADS)] and coping strategies [abbreviated version of the Coping Orientation to Problems Experienced (Brief-COPE)]. T-test and logistic regression analyses were performed to investigate factors associated with medication adherence.
RESULTS: The participants, 74 men and 46 women, reported a mean age of 56.65 ± 15.80 years. The results showed that 71.67% of the patients were adherent while 28.33% were non-adherent. Furthermore, adherence was positively associated with active coping (P < 0.050) and instrumental support (P < 0.001). Also, depression symptoms were risk factor for non-adherence (P < 0.050).
CONCLUSION: This study suggests that active coping strategies with a good level of instrumental support are factors associated with greater adherence to long-term therapy. The results of this study support paying attention to factors identified as being helpful in monitoring patients with a risk of non-adherence. There is a need to provide increased psychosocial support for patients with chronic disease by planning effective client‐focused interventions.
References
Jabbour EJ, Kantarjian H, Eliasson L, Cornelison AM, Marin D. Patient adherence to tyrosine kinase inhibitor therapy in chronic myeloid leukemia. Am J Hematol 2012; 87(7): 687-91.
World Health Organization. Innovative Care for Chronic Conditions: Building Blocks for Action [Online]. [cited 2014]; Available from: URL: https://www.who.int/chp/knowledge/publications/icccreport/en
Hall AE, Paul C, Bryant J, Lynagh MC, Rowlings P, Enjeti A, et al. To adhere or not to adhere: Rates and reasons of medication adherence in hematological cancer patients. Crit Rev Oncol Hematol 2016; 97: 247-62.
Verbrugghe M, Verhaeghe S, Lauwaert K, Beeckman D, Van Hacke A. Determinants and associated factors influencing medication adherence and persistence to oral anticancer drugs: A systematic review. Cancer Treat Rev 2013; 39(6): 610-21.
Efficace F, Baccarani M, Rosti G, Cottone F, Castagnetti F, Breccia M, et al. Investigating factors associated with adherence behaviour in patients with chronic myeloid leukemia: An observational patient-centered outcome study. Br J Cancer 2012; 107(6): 904-9.
Marin D, Bazeos A, Mahon FX, Eliasson L, Milojkovic D, Bua M, et al. Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. J Clin Oncol 2010; 28(14): 2381-8.
Santoleri F, Lasala R, Ranucci E, La Barba G, Di Lorenzo R, Vetro A, et al. Medication adherence to tyrosine kinase inhibitors: 2-year analysis of medication adherence to imatinib treatment for chronic myeloid leukemia and correlation with the depth of molecular response. Acta Haematol 2016; 136(1): 45-51.
Hwang HC, Kim HR, Han DH, Hong JS, Jeong SH, Shin JH, et al. Influence of major coping strategies on treatment non-adherence and severity of comorbid conditions in hemodialysis patients. J Korean Med Sci 2018; 33(20): e148.
Lazarus RS, Folkman S. Stress, appraisal, and coping. Berlin, Germany: Springer Publishing Company; 1984.
Sahar K, Thomas SA, Clarke SP. Adjustment to fibromyalgia: The role of domain-specific self-efficacy and acceptance. Aust J Psychol 2016; 68(1): 29-374.
DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160(14): 2101-7.
Dogu MH, Eren R, Yilmaz E, Nizam N, Aslan C, Yokus O, et al. Are We Aware of Anxiety and Depression in Patients with Newly Diagnosed Acute Leukemia? J Gen Pract (Los Angel) 2017; 5(5): 1-4.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002; 52(2): 69-77.
Janezic A, Locatelli I, Kos M. Criterion validity of 8-item Morisky Medication Adherence Scale in patients with asthma. PLoS One 2017; 12(11): e0187835.
Carver CS. You want to measure coping but your protocol's too long: Consider the brief COPE. Int J Behav Med 1997; 4(1): 92-100.
Unnikrishnan R, Veeraiah S, Mani S, Rajendranath R, Rajaraman S, Vidhubala Elangovan GS, et al. Comprehensive evaluation of adherence to therapy, its associations, and its implications in patients with chronic myeloid leukemia receiving imatinib. Clin Lymphoma Myeloma Leuk 2016; 16(6): 366-71.
Geissler J, Sharf G, Bombaci F, Daban M, De Jong J, Gavin T, et al. Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries. J Cancer Res Clin Oncol 2017; 143(7): 1167-76.
Conti C, Di Francesco G, Fontanella L, Carrozzino D, Patierno C, Vitacolonna E, et al. Negative affectivity predicts lower quality of life and metabolic control in type 2 diabetes patients: A structural equation modeling approach. Front Psychol 2017; 8: 831.
Alcalar N, Ozkan S, Kucucuk S, Aslay I, Ozkan M. Association of coping style, cognitive errors and cancer-related variables with depression in women treated for breast cancer. Jpn J Clin Oncol 2012; 42(10): 940-7.
Morris N, Moghaddam N, Tickle A, Biswas S. The relationship between coping style and psychological distress in people with head and neck cancer: A systematic review. Psychooncology 2018; 27(3): 734-47.
