The University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599-7460, USA.
Medicine and Population Health, Duke University School of Medicine and the Duke Cancer Institute, Durham, NC, USA.
Support Care Cancer. 2020 Nov;28(11):5157-5164. doi: 10.1007/s00520-020-05349-5. Epub 2020 Feb 14.
The incidence of AML is increasing, in part due to an aging population. Since 2017, eight novel agents have been introduced, 6 of which are oral: midostaurin, enasidenib, ivosidenib, gilteritinib, glasdegib, and venetoclax. With an increase in oral medications (OMs), patients face associated side effects that accompany OMs, which often decreases adherence. We aimed to identify and summarize adherence to OMs in this population.
Our mixed method design used focus groups (FG) and patient surveys. After IRB approval, 11 patients and 4 caregivers participated in 4 FGs. Themes from the FGs were used to develop a 37-item OMs adherence needs assessment. Participants were recruited and consented at three cancer centers to complete surveys (online, at the clinic, hospital, or from home).
A total of 100 patients completed OMs survey. The number of pills to be taken was the most frequent and troublesome challenge. The most frequently reported interventions that would improve patient adherence were smaller pills, easier packaging, and scheduling assistance. Nearly 33% of patients indicated they skip OMs dose altogether when they forget to take it. Younger patients (< 65 years) were more accepting of taking oral compared with intravenous medications (p = .03).
This study represents the first assessment of OMs adherence in adults with AML. Findings provide the basis for further exploration of interventions to enhance and increase adherence to OMs regimens.
AML 的发病率正在上升，部分原因是人口老龄化。自 2017 年以来，已经引入了八种新型药物，其中六种是口服药物：米哚妥林、依维莫司、ivosidenib、吉特替尼、glasdegib 和 venetoclax。随着口服药物（OMs）的增加，患者面临伴随 OMs 的相关副作用，这通常会降低依从性。我们旨在确定并总结这一人群对 OMs 的依从性。
我们的混合方法设计使用了焦点小组（FG）和患者调查。在获得 IRB 批准后，11 名患者和 4 名护理人员参加了 4 个 FG。FG 中的主题被用于开发一个 37 项 OMs 依从性需求评估。参与者在三个癌症中心招募并同意完成调查（在线、在诊所、医院或从家中）。
共有 100 名患者完成了 OMs 调查。需要服用的药丸数量是最常见和最麻烦的挑战。最常报告的可以提高患者依从性的干预措施是服用更小的药丸、更简单的包装和安排协助。近 33%的患者表示，当他们忘记服药时，他们会完全跳过 OMs 剂量。年龄较小的患者（<65 岁）比静脉内药物更愿意服用口服药物（p=0.03）。
这项研究代表了对成人 AML 患者 OMs 依从性的首次评估。研究结果为进一步探索增强和增加 OMs 方案依从性的干预措施提供了基础。
