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探讨慢性髓性白血病患者未按规定服用口服抗癌药物伊马替尼的原因。

Exploring chronic myeloid leukemia patients' reasons for not adhering to the oral anticancer drug imatinib as prescribed.

机构信息

Centre for Medication Safety and Service Quality, Department of Practice and Policy, The School of Pharmacy, University of London, London, UK.

出版信息

Leuk Res. 2011 May;35(5):626-30. doi: 10.1016/j.leukres.2010.10.017. Epub 2010 Nov 20.

Abstract

Nonadherence has been shown to be frequent amongst chronic myeloid leukemia (CML) patients prescribed imatinib, which results in reduced clinical response and increased healthcare costs. However, little is known about the reasons why CML patients frequently do not take their imatinib as prescribed. The current study explored CML patients' experience of taking, or not taking, imatinib therapy through in-depth interviews with twenty-one patients. Their adherence had been previously measured using a medication events monitoring device. The interviews were recorded, transcribed and analysed in accordance with established techniques. Patients revealed a variety of reasons for their nonadherence. Major themes that emerged from the data were the intentional and unintentional reasons for nonadherence. Furthermore, as a result of information received from health care professionals, several patients felt inappropriately reassured that their nonadherence would not have a detrimental effect on their clinical response. Factors that seemed to favour adherence were finding ways to deal with side effects and using prompts as reminders to take the medicine. This study forms a basis on which to build future adherence research and may help to develop interventions designed to ensure that patients with CML and other cancers adhere optimally to their oral drugs treatment.

摘要

非依从性在接受伊马替尼治疗的慢性髓性白血病 (CML) 患者中较为常见,这会导致临床反应降低和医疗保健费用增加。然而,对于 CML 患者经常不按规定服用伊马替尼的原因知之甚少。本研究通过对 21 名患者进行深入访谈,探讨了 CML 患者服用或不服用伊马替尼治疗的体验。他们的依从性此前已通过药物事件监测设备进行测量。访谈按照既定技术进行记录、转录和分析。患者透露了他们不依从的各种原因。从数据中出现的主要主题是不依从的有意和无意原因。此外,由于从医疗保健专业人员那里获得的信息,一些患者感到被不恰当地安慰,认为他们的不依从不会对他们的临床反应产生不利影响。有利于依从性的因素包括寻找应对副作用的方法和使用提示作为服药的提醒。这项研究为未来的依从性研究奠定了基础,并可能有助于开发旨在确保 CML 和其他癌症患者最佳服用口服药物治疗的干预措施。

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