FACTORS INFLUENCING ADHERENCE TO IMATINIB IN INDIAN CHRONIC MYELOID LEUKEMIA PATIENTS: A CROSS-SECTIONAL STUDY

Main Article Content

Jyotsna Kapoor
Narendra Agrawal
Rayaz Ahmad
Sanjeev Kumar Sharma
Anshul Gupta
Dinesh Bhurani

Keywords

Chronic Myeloid Leukemia, Adherence, Imatinib, Nine Item Morisky Medication Adherence Scale, Patient Health Questionnaire - 9.

Abstract

Adherence to imatinib(IM) is of utmost importance in patients with chronic myeloid leukemia(CML) to maximise treatment effectiveness. The main objective is to measure adherence to    IM & to evaluate individual patient characteristics, personal, treatment related &                    psychological factors influencing adherence behaviour. Hundred patients  receiving IM were analysed for adherence behaviour using 9 item Morisky Medication Adherence Scale              (9-MMAS) . Various factors were assessed for their impact on adherence behaviour.  These   factors were age, gender, duration of treatment, frequency & dosing of treatment, use  of        tobacco & alcohol, educational qualification,employment status,monthly  income, side effects, financial assistance in treatment, social support, knowledge about medicine & disease,         concomitant drug burden, polypharmacy, physician patient interaction, patient  educational    sessions & prevalence of depression. Seventy five percent of patients were found to be           adherent. On univariate analysis, prevalence of depression (p<0.000001), moderate severe     depression (p<0.000001), concomitant drug burden (p=0.036) & monthly income (p=0.015) were found to be significantly influencing adherence. The final multivariate model retained   prevalence of depression with OR= 10.367  (95% CI, 3.112- 34.538) as independent predictor of adherence to therapy. This study suggests that identification & treatment of depression among CML patients may further enhance adherence to IM therapy.

Keywords: Chronic Myeloid Leukemia, Adherence, Imatinib, Nine Item Morisky Medication Adherence Scale, Patient Health Questionnaire -9.

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