Browsing by Subject "tyrosiinikinaasinestäjä"

Chronic myeloid leukemia (CML) is a malignant hematologic disorder, which is fatal without a treatment. Oral tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of CML and transformed the disease to a chronic condition that can be treated at patient's home. The common problem in the treatment of CML is patient's poor adherence to TKIs. The regular, consistent use of TKIs is crucial to keep disease under control. For this reason and to obtain an optimal treatment outcome, adherence to TKIs is extremely important. The aim of the study was to assess reasons for poor adherence to TKI-medications in Finnish CMLpatients, including patient characteristics, treatment related factors, comorbidities and concomitant medications. In addition, patients' experiences, beliefs, knowledge and perception about CML and its treatment were explored and how these could contribute to nonadherent behaviour. This study is part of the larger study, assessing adherence to TKI treatment among Finnish CML population. The data was obtained by using patient questionnaires and semi-structured theme-interview during patient meetings in 2012. Study population consisted of Finnish adult CML patients who had been on TKI -medication (imatinib, nilotinib or dasatinib) for more than six months prior to the study baseline. Patients' adherence was measured using Morisky Medication Adherence 8-Item Scale (MMAS-8) and based on their score, patients were divided into three groups: high, medium and low adherence. Both quantitative and qualitative methods were used in data analysis. Study findings show that 21% (n=18) of the patients were low adherent and 23% (n=20) were high adherent to their treatment. Patient sociodemographic characteristics or experienced adverse drug reactions (ADRs) did not predict adherence, while more concomitant medications and comorbidities were associated with high adherence. However, ADRs had negative effect on the quality of life of several nonadherent patients. All nonadherent patients reported unintentional nonadherence and the most common reason was forgetting. Two-thirds of the patients (n=12) reported intentional nonadherence, which often was a result of experienced ADRs. The knowledge of CML and its treatment was poor among all patients while over half of the nonadherent patients (n=11) thought that they received enough information received. Overall, patients were very satisfied with care provided by the hospitals, physicians and other healthcare professionals. Managing TKI-treatment regimen is challenging for many patients and ADRs can have a negative impact on the quality of life. Healthcare professionals should regularly assess patient adherence and provide information and support for the patients to help them to succeed in medication management. Reasons for poor adherence are complex and have to be identified from each individual patient so that adherence can be improved.