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了解成人急性髓系白血病口服治疗依从性的障碍

Understanding Barriers to Oral Therapy Adherence in Adults With Acute Myeloid Leukemia.

作者信息

Bryant Ashley Leak, Chan Ya-Ning, Richardson Jaime, Foster Matthew, Owenby Susie, Wujcik Debra

机构信息

The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Carevive Systems, Inc., North Miami, Florida.

出版信息

J Adv Pract Oncol. 2020 May-Jun;11(4):342-349. doi: 10.6004/jadpro.2020.11.4.2. Epub 2020 May 1.

Abstract

Acute myeloid leukemia (AML) is a disease of older adults, with a median age at diagnosis of 68 years. The availability of oral anticancer medications has increased, although the standard treatment for AML remains in intravenous form. We aim to identify barriers to adherence to oral medications in patients with AML and proposed solutions for improvements. Following institutional review board approval, patients with AML and their caregivers were recruited to participate in focus groups. Sessions were digitally recorded, transcribed verbatim, and analyzed for thematic content using Dedoose qualitative software. 11 patients (five < 65 years; six ≥ 65 years) and 4 caregivers participated in these sessions. Three central themes emerged: 1) medication adherence challenges, 2) managing an oral adherence plan, and 3) strategies to improve oral adherence. Participants recommended written schedules, taking medications around meals, and using pillboxes and alarms. We believe that patients are an important source of insight into barriers and solutions to oral medication adherence.

摘要

急性髓系白血病(AML)是一种多见于老年人的疾病,诊断时的中位年龄为68岁。尽管AML的标准治疗仍为静脉给药形式,但口服抗癌药物的可及性有所增加。我们旨在确定AML患者口服药物治疗的依从性障碍,并提出改进方案。经机构审查委员会批准,招募了AML患者及其护理人员参加焦点小组。会议进行了数字录音,逐字转录,并使用Dedoose定性软件分析主题内容。11名患者(5名年龄小于65岁;6名年龄大于等于65岁)和4名护理人员参加了这些会议。出现了三个核心主题:1)药物治疗依从性挑战,2)管理口服治疗依从性计划,3)提高口服治疗依从性的策略。参与者建议采用书面时间表、在进餐时间左右服药、使用药盒和闹钟。我们认为,患者是了解口服药物治疗依从性障碍及解决方案的重要信息来源。

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