Patient adherence to tyrosine kinase inhibitor therapy in chronic myeloid leukemia: influence of coping strategies and psychological factors

Giulia Di Francesco, Pierpaola Sciarra, Valeria Ballarini, Gaetano La Barba, Paolo Di Bartolomeo

DOI: 10.22122/cdj.v0i0.526


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.


Adherence; Chronic Myeloid Leukemia; Coping Strategies; Anxiety; Depression

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