Italian Group for Adult Hematologic Diseases, Data Center and Health Outcomes Research Unit, Via Benevento, 6, 00161 Rome, Italy.
Br J Cancer. 2012 Sep 4;107(6):904-9. doi: 10.1038/bjc.2012.348. Epub 2012 Aug 7.
Optimal adherence to imatinib therapy is of paramount importance to maximise treatment effectiveness in patients with chronic myeloid leukaemia (CML). The main objective of this study was to investigate patient-reported personal factors associated with adherence behaviour.
Analysis was conducted on 413 CML patients receiving long-term therapy with imatinib. Adherence behaviour was measured with the Morisky Medication Adherence Scale and personal factors investigated included: quality of life, perceived social support, fatigue, symptom burden, psychological wellbeing and desire for additional information. Key socio-demographic and treatment-related factors were also taken into account. Univariate and multivariate logistic regression analyses were used to investigate factors associated with optimal adherence to therapy.
In all, 53% of patients reported an optimal adherence behaviour. The final multivariate model retained the following variables as independent predictors of optimal adherence to therapy: desire for more information (ref. no), odds ratio (OR)=0.43 (95% confidence interval (CI), 0.29-0.66; P<0.001), social support (higher score representing greater support), OR=1.29 (95% CI, 1.11-1.49; P<0.001) and concomitant drug burden (ref. no), OR=1.82 (95% CI, 1.18-2.80; P=0.006).
This study suggests that a higher level of social support, satisfaction with information received and concomitant drug burden are the main factors associated with greater adherence to long-term imatinib therapy.
在慢性髓性白血病(CML)患者中,最佳的伊马替尼治疗依从性对于最大限度地提高治疗效果至关重要。本研究的主要目的是调查与依从性行为相关的患者报告的个人因素。
对 413 名接受伊马替尼长期治疗的 CML 患者进行了分析。依从性行为采用 Morisky 药物依从性量表进行测量,调查的个人因素包括:生活质量、感知社会支持、疲劳、症状负担、心理幸福感和获取额外信息的愿望。还考虑了关键的社会人口统计学和治疗相关因素。使用单变量和多变量逻辑回归分析来研究与最佳治疗依从性相关的因素。
在所有患者中,有 53%报告了最佳的依从性行为。最终的多变量模型保留了以下变量作为治疗依从性的独立预测因素:对更多信息的渴望(无),比值比(OR)=0.43(95%置信区间(CI),0.29-0.66;P<0.001),社会支持(更高的分数表示更大的支持),OR=1.29(95%CI,1.11-1.49;P<0.001)和伴随药物负担(无),OR=1.82(95%CI,1.18-2.80;P=0.006)。
本研究表明,更高水平的社会支持、对所获得信息的满意度和伴随药物负担是与长期伊马替尼治疗依从性更高相关的主要因素。