Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting
2.2. Research Training and Participant Recruitment
2.3. Study Measures
2.4. Adherence
2.5. Statistical Analysis
3. Results
3.1. Medication Adherence
3.2. Medication Beliefs and Barriers
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Verbrugghe, M.; Verhaeghe, S.; Lauwaert, K.; Beeckman, D.; Van Hecke, A. Determinants and associated factors influencing medication adherence and persistence to oral anticancer drugs: A systematic review. Cancer Treat. Rev. 2013, 39, 610–621. [Google Scholar] [CrossRef]
- Thompson, N.; Christian, A. Oral chemotherapy: Not just an ordinary pill. Am. Nurse Today 2016, 11, 16–21. [Google Scholar]
- Weingart, S.N.; Brown, E.; Bach, P.B.; Eng, K.; Johnson, S.A.; Kuzel, T.M.; Langbaum, T.S.; Leedy, R.D.; Muller, R.J.; Newcomer, L.N.; et al. NCCN task force report: Oral chemotherapy. J. Natl. Compr. Cancer Netw. 2008, 6, S1–S14. [Google Scholar] [CrossRef]
- Noens, L.; Van Lierde, M.A.; De Bock, R.; Verhoef, G.; Zachée, P.; Berneman, Z.; Martiat, P.; Mineur, P.; Van Eygen, K.; MacDonald, K.; et al. Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: The ADAGIO study. Blood J. Am. Soc. Hematol. 2009, 113, 5401–5411. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Darkow, T.; Henk, H.J.; Thomas, S.K.; Feng, W.; Baladi, J.; Goldberg, G.; Hatfield, A.; Cortes, J. Treatment interruptions and non-adherence with imatinib and associated healthcare costs: A retrospective analysis among managed care patients with chronic myelogenous leukaemia. PharmacoEconomics 2007, 25, 481–496. [Google Scholar] [CrossRef]
- Larizza, M.A.; Dooley, M.H.; Stewart, K.; Kong, D. Factors influencing adherence to molecular therapies in haematology-oncology outpatients. J. Pharm. Pract. Res. 2006, 36, 115–118. [Google Scholar] [CrossRef]
- McCue, D.A.; Lohr, L.K.; Pick, A.M. Improving adherence to oral cancer therapy in clinical practice. Pharmacotherapy 2014, 34, 481–494. [Google Scholar] [CrossRef] [PubMed]
- Mathes, T.; Peiper, D.; Antoine, S.L.; Eikermann, M. Adherence influencing factors in patients taking oral anticancer agents: A systematic review. Cancer Epidemiol. 2014, 38, 214–226. [Google Scholar] [CrossRef] [PubMed]
- Schellens, J.H. Challenges of oral chemotherapy. Clin. Adv. Hematol. Oncol. 2005, 3, 99–100. [Google Scholar] [PubMed]
- Sabate, E. Adherence to Long-Term Therapies: Evidence for Action; World Health Organization: Geneva, Switzerland, 2003; Available online: https://www.who.int/chp/knowledge/publications/adherence_full_report.pdf (accessed on 1 March 2020).
- McLeod, H.L.; Evans, W.E. Oral cancer chemotherapy: The promise and the pitfalls. Clin. Cancer Res. 1999, 5, 2669–2671. [Google Scholar]
- Osterberg, L.; Blaschke, T. Adherence to medication. N. Engl. J. Med. 2015, 353, 487–497. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Lam, W.Y.; Fresco, P. Medication adherence measures: An overview. BioMed Res. Int. 2015, 2015, 217047. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jabbour, E.; Saglio, G.; Radich, J.; Kantarjian, H. Adherence to BCR-ABL inhibitors: Issues for CML therapy. Clin. Lymphoma Myeloma Leuk. 2012, 12, 223–229. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- National Cancer Institute Cancer Stat Facts: Leukemia—Chronic Myeloid Leukemia (CML). Surveillance, Epidemiology, and End Results Program. Available online: https://seer.cancer.gov/statfacts/html/cmyl.html (accessed on 1 January 2021).
- Marin, D.; Bazeos, A.; Mahon, F.X.; Eliasson, L.; Milojkovic, D.; Bua, M.; Apperley, J.; Szydlo, R.; Desai, R.; Kozlowski, K.; et al. Adherence in the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. J. Clin. Oncol. 2010, 28, 2381–2388. [Google Scholar] [CrossRef] [PubMed]
- Noens, L.; Hensen, M.; Kucmin–Bemelman, S.I.; Lofgren, C.; Gilloteau, I.; Vrijens, B. Measurement of adherence of BCR- ABL inhibitor therapy in chronic myeloid leukemia: Current situation and future challenges. Hematologica 2014, 99, 437. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ibrahim, A.R.; Eliasson, L.; Apperley, J.F.; Milojkovic, D.; Bua, M.; Szydlo, R.; Mahon, F.; Kozlowski, K.; Paliompeis, C.; Foroni, L.; et al. Poor adherence is the main reason for loss of CCyR and imatinib failure for chronic myeloid leukemia patients on long-term therapy. Blood 2011, 117, 3733–3736. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Buzaglo, J.; Miller, M.; Karten, C.; Longacre, M.; Eberechukwu, O.; Weiss, E.; Greer, J.; Golant, M.; Mauro, M. Medication adherence among patients with chronic myeloid leukemia: The impact of financial burden and psychosocial distress. J. Oncol. Navig. Surviv. 2017, 8, 168–175. [Google Scholar]
- Oehler, V.A. Update on current monitoring recommendation in chronic myeloid leukemia: Practical points for clinical practice. Hematol. Am. Soc. Hematol. Educ. Program 2013, 2013, 176–183. [Google Scholar] [CrossRef] [PubMed]
- Hall, A.E.; Paul, C.; Bryant, J.; Lynagh, M.; Rowlings, P.; Enjeti, A.; Small, H. To adhere or not to adhere: Rates and reasons of medication adherence in hematological cancer patients. Crit. Rev. Oncol. Hematol. 2016, 97, 247–262. [Google Scholar] [CrossRef] [PubMed]
- Koren-Michowitz, M.; Volchek, Y.; Naparstek, E.; Gavish, I.; Levi, I.; Rowe, J.; Shimoni, A.; Nagler, A. Imatinib plasma trough levels in chronic myeloid leukaemia: Results of a multicentre study CSTI571AIL11TGLIVEC. Hematol Oncol. 2012, 30, 200–205. [Google Scholar] [CrossRef] [PubMed]
- de Almeida, M.H.; Pagnano, K.B.; Vigorito, A.C.; Lorand-Metze, I.; de Souza, C.A. Adherence to tyrosine kinase inhibitor therapy for chronic myeloid leukemia: A Brazilian single-center cohort. Acta Haematol 2013, 130, 16–22. [Google Scholar] [CrossRef] [PubMed]
- Guilhot, F.; Coombs, J.; Zernovak, O.; Szczudlo, T.; Rosti, G. A Global retrospective and physician-based analysis of adherence to tyrosine kinase inhibitor (TKI) therapies for chronic myeloid leukemia (CML). Blood 2010, 116, 1514. [Google Scholar] [CrossRef]
- Daouphars, M.; Ouvry, M.; Lenain, P.; Rouvet, J.; Jardin, F.; Bubenheim, M.; Varin, R. Preliminary validation of self-assessment tool to measure imatinib adherence in patients with chronic myeloid leukemia. Pharmacotherapy 2013, 33, 152–156. [Google Scholar] [CrossRef] [PubMed]
- Krikorian, S.; Pories, S.; Tataronis, G.; Caughey, T.; Chervinsky, K.; Lotz, M.; Shen, A.; Weissmann, L. Adherence to oral chemotherapy: Challenges and opportunities. J. Oncol. Pharm. Pract. 2019, 25, 1590–1598. [Google Scholar] [CrossRef] [PubMed]
- Santoleri, F.; Lasala, R.; Logreco, A.; Ranucci, E.; Costantini, A. Using a treatment diary to improve the medication adherence in patients with chronic myeloid leukemia. J. Oncol. Pharm. Pract. 2019, 25, 1035–1041. [Google Scholar] [CrossRef] [PubMed]
- Jacobs, J.; Pensak, N.; Sporn, N.; MacDonald, J.; Lennes, I.; Safren, S.; Pirl, W.; Temel, J.; Greer, J. Treatment satisfaction and adherence to oral chemotherapy in patients with cancer. J. Oncol. Pract. 2017, 13, e474–e485. [Google Scholar] [CrossRef] [PubMed]
- Timmers, L.; Boons, C.; Verbrugghe, M.; van den Bemt, B.; Van Hecke, A.; Hugtenburg, J. Supporting adherence to oral anticancer agents: Clinical practice and clues to improve care provided by physicians, nurse practitioners, nurses and pharmacists. BMC Cancer 2017, 17, 122. [Google Scholar] [CrossRef] [Green Version]
- Geissler, J.; Sharf, G.; Bombaci, F.; Daban, M.; De Jong, J.; Gavin, T.; Pelouchova, J.; Dziwinski, E.; Hasford, J.; Hoffmann, V. Factors influencing adherence in CML and ways to improvement: Results of a patient-driven survey of 2546 patients in 63 countries. J. Cancer Res. Clin. Oncol. 2017, 143, 1167–1176. [Google Scholar] [CrossRef]
- Tan, X.; Patel, I.; Chang, J. Review of the four item Morisky Medication Adherence Scale (MMAS-4) and eight item Morisky Medication Adherence Scale (MMAS-8). Innov. Pharm. 2014, 5, 5. [Google Scholar] [CrossRef]
- Kutner, M.; Greenberg, E.; Jin, Y.; Paulsen, C. The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy; NCES: Washington, DC, USA, 2006; pp. 1–76.
- Wu, J.; DeWalt, D.; Baker, D.; Schillinger, D.; Ruo, B.; Bibbins-Domingo, K.; Macabasco-O’Connell, A.; Holmes, G.; Broucksou, K.; Erman, B.; et al. A single-item self-report medication adherence question predicts hospitalisation and death in patients with heart failure. J. Clin. Nurs. 2014, 23, 2554–2564. [Google Scholar] [CrossRef] [PubMed]
- Unni, E.J.; Farris, K.B. Development of a new scale to measure self-reported medication nonadherence. Res. Soc. Adm. Pharm. 2015, 11, 133–143. [Google Scholar] [CrossRef] [PubMed]
- Unni, E.J.; Sternbach, N.; Goren, A. Using the Medication Adherence Reasons Scale (MAR-Scale) to identify the reasons for nonadherence across multiple disease conditions. Patient Prefer. Adherence 2019, 13, 933–1004. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Svarstad, B.; Chewning, B.; Sleath, B.; Claesson, C. The brief medication questionnaire: A tool for screening patient adherence and barriers to adherence. Patient Educ. Couns. 1999, 37, 113–124. [Google Scholar] [CrossRef]
- Feldman, B.J.; Fredericksen, R.J.; Crane, P.K.; Safren, S.A.; Mugavero, M.J.; Willig, J.H.; Simoni, J.M.; Wilson, I.B.; Saag, M.S.; Kitahata, M.M.; et al. Evaluation of the Single-Item Self-Rating Adherence Scale for use in routine clinical care of people living with HIV. AIDS Behav. 2013, 17, 307–318. [Google Scholar] [CrossRef]
- Lu, M.; Safren, S.; Skolnik, P.; Rogers, W.; Coady, W.; Hardy, H.; Wilson, I. Optimal recall period and response task for self-reported HIV medication adherence. AIDS Behav. 2008, 12, 86–94. [Google Scholar] [CrossRef]
- Medical Event Monitoring System (MEMS). Available online: https://www.westrock.com/en/products/folding-cartons/memscap (accessed on 1 January 2021).
- Arozullah, A.; Yarnold, P.; Bennett, C.; Soltysik, R.; Wolf, M.; Ferreira, R.; Lee, S.; Costello, S.; Shakir, A.; Denwood, C.; et al. Development and validation of a short-form, rapid estimate of adult literacy in medicine. Med. Care 2007, 45, 1026–1033. [Google Scholar] [CrossRef]
- SAS Institute SAS Analytics Software and Solutions (Computer Software). Available online: https://www.sas.com/en_us/software/all-products.html (accessed on 1 January 2021).
- Efficace, F.; Rosti, G.; Cottone, F.; Breccia, M.; Castagnetti, F.; Iurlo, A.; Mandelli, F.; Baccarani, M. Profiling chronic myeloid leukemia patients reporting intentional and unintentional non-adherence to lifelong therapy with tyrosine kinase inhibitors. Leuk. Res. 2014, 38, 294–298. [Google Scholar] [CrossRef]
- Anderson, K.; Chambers, C.; Lam, N.; Yau, P.; Cusano, F.; Savoie, M.; Sheikh, N. Medication adherence among adults prescribed imatinib, dasatinib, or nilontinib for treatment of chronic myeloid leukemia. J. Oncol. Pharm. Pract. 2015, 21, 19–25. [Google Scholar] [CrossRef]
- Abraham, I.; MacDonald, K. Why are patients with chronic myeloid leukemia (non) adherent? Br. J. Cancer 2012, 107, 901–903. [Google Scholar] [CrossRef]
- Talens, A.; Guilabert, M.; Lumbreras, B.; Aznar, M.; López-Pintor, E. Medication experience and adherence to oral chemotherapy: A qualitative study of patients’ and health professionals’ perspectives. Int. J. Environ. Res. Public Health 2021, 18, 4266. [Google Scholar] [CrossRef]
- Gandhi, S.; Day, L.; Paramsothy, T.; Giotis, A.; Ford, M.; Boudreau, A.; Pasetka, M. Oral anticancer medication adherence, toxicity reporting, and counseling: A study comparing health care providers and patients. J. Oncol. Pract. 2015, 11, 498–504. [Google Scholar] [CrossRef]
- Wolf, M.S.; Curtis, L.; Waite, K.; Bailey, S.C.; Hedlund, L.A.; Davis, T.C.; Shrank, W.H.; Parker, R.; Wood, A. Helping patients simplify and safely use complex prescription regimens. Arch. Intern. Med. 2011, 171, 300–305. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cameron, K.A.; Ross, E.L.; Clayman, M.L.; Bergeron, A.R.; Federman, A.D.; Bailey, S.C.; Davis, T.C.; Wolf, M.S. Measuring patients’ self-efficacy in understanding and using prescription medication. Patient Educ. Couns. 2010, 80, 372–376. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bailey, S.C.; Shrank, W.; Davis, T.C.; Parker, R.M.; Wolf, M.S. Medication label improvement: An issue at the intersection of health literacy and patient safety. J. Commun. Healthc. 2009, 2, 294–307. [Google Scholar] [CrossRef]
- Bailey, S.C.; Pandit, A.U.; Yin, S.; Federman, A.; Davis, T.C.; Parker, R.M.; Wolf, M.S. Predictors of misunderstanding pediatric liquid medication instructions. Fam. Med. 2009, 41, 715–721. [Google Scholar] [PubMed]
- Davis, T.C.; Federman, A.D.; Bass, P.F.; Jackson, R.H.; Middlebrooks, M.; Parker, R.M.; Wolf, M.S. Improving patient understanding of prescription drug label instructions. J. Gen. Intern. Med. 2009, 24, 57–62. [Google Scholar] [CrossRef] [Green Version]
- Waite, K.; Davis, T.C.; Paasche-Orlow, M.K.; Rintamaki, L.; Wolf, M.S. Literacy, social stigma, and HIV medication adherence. J. Gen. Intern. Med. 2008, 23, 1367–1372. [Google Scholar] [CrossRef] [Green Version]
- Davis, T.C.; Morris, J.; Rademaker, A.; Ferguson, L.A.; Arnold, C.L. Barriers and facilitators to colorectal cancer screening among rural women in community clinics by heath literacy. J. Women’s Health Issues Care 2017, 6, 1000292. [Google Scholar] [CrossRef]
- Arnold, C.L.; Rademaker, A.; Liu, D.; Davis, T.C. Changes in colorectal cancer screening knowledge, behavior, beliefs, self-efficacy, and barriers among community health clinic patients after a health literacy intervention. J. Community Med. Health Educ. 2017, 7, 497. [Google Scholar]
- Arnold, C.; Rademaker, A.; Wolf, M.S.; Liu, D.; Hancock, J.; Davis, T.C. 3rd annual fecal occult blood testing in community health clinics. Am. J. Health Behav. 2016, 40, 302–309. [Google Scholar] [CrossRef] [Green Version]
- Davis, T.C.; Arnold, C.; Bennett, C.; Wolf, M.S.; Liu, D.; Rademaker, A. Sustaining mammography screening among the medically underserved: A follow-up evaluation. J. Women’s Health 2015, 24, 291–298. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Davis, T.C.; Rademaker, A.; Bennett, C.; Wolf, M.; Carias, E.; Reynolds, C.; Liu, D.; Arnold, C. Improving mammography screening among the medically underserved. J. Gen. Intern. Med. 2014, 29, 628–635. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Davis, T.C.; Arnold, C.L.; Bennett, C.L.; Wolf, M.S.; Reynolds, C.R.; Liu, D.; Rademaker, A. Strategies to improve repeat fecal occult blood testing cancer screening. Cancer Epidemiol. Prev. Biomarkers 2014, 23, 134–143. [Google Scholar] [CrossRef] [Green Version]
- Davis, T.C.; Arnold, C.; Rademaker, A.; Bennett, C.; Bailey, S.; Platt, D.; Reynolds, C.; Liu, D.; Carias, E.; Bass, P.; et al. Improving colorectal cancer screening in community clinics. Cancer 2013, 119, 3879–3886. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Arnold, C.L.; Rademaker, A.; Platt, D.J.; Liu, D.; Esparza, J.; Davis, T.C. Literacy barriers to colorectal cancer screening in community clinics. J. Health Commun. 2012, 17, 252–264. [Google Scholar] [CrossRef] [PubMed]
- National Institute of Health Clear Communication: Health Literacy. Available online: https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/clear-communication/health-literacy (accessed on 1 January 2021).
- U.S. Department of Health and Human Services National Action Plan to Improve Health Literacy. Available online: https://health.gov/our-work/national-health-initiatives/health-literacy/national-action-plan-improve-health-literacy (accessed on 1 January 2021).
- Wolf, M.; Bennett, C.; Davis, T.; Marin, E.; Arnold, C. A qualitative study of literacy and patient response to HIV medication adherence questionnaires. J. Health Commun. 2005, 10, 509–517. [Google Scholar] [CrossRef]
Over the Past 7 Days, How Many Times Did You Miss a Dose of Your CML Medication? | ||||
---|---|---|---|---|
Demographics | Overall (n = 86) | 0 Times (n = 70) | ≥1 Time (n = 16) | p-Value |
Age at registration (years) | 58.67 ± 14.95 (57.24) | 58.33 ± 14.91 (58.02) | 60.16 ± 15.50 (55.33) | 0.66 |
BMI (kg/m2) | 32.05 (7.13) 30.96 | 31.31 (6.18) 30.74 | 35.28 (9.93) 33.76 | 0.05 * |
n (%) | n (%) | n (%) | p-value | |
Gender | 0.10 | |||
Female | 38 (44.2) | 28 (40.0) | 10 (62.5) | |
Male | 48 (55.8) | 42 (60.0) | 6 (37.5) | |
Race | 1.00 | |||
Non-Hispanic White | 76 (88.4) | 62 (88.6) | 14 (87.5) | |
Non-Hispanic Black | 6 (7) | 4 (5.7) | 2 (12.5) | |
Other | 4 (4.7) | 4 (5.7) | 0 (0) | |
Insurance | ||||
VA care (yes) | 1 (1.2) | 1 (1.4) | 0 (0) | N/A |
Medicare (yes) | 29 (33.7) | 23 (32.9) | 6 (37.5) | 0.77 |
Medicaid (yes) | 6 (7) | 5 (7.1) | 1 (6.3) | 1.00 |
Private Insurance (yes) | 65 (75.6) | 53 (75.7) | 12 (75.0) | 1.00 |
Tricare (yes) | 2 (2.3) | 2 (2.9) | 0 (0) | N/A |
No Insurance (yes) | 1 (1.2) | 1 (1.4) | 0 (0) | N/A |
Other prescriptions | 0.18 | |||
1 | 22 (25.6) | 16 (22.9) | 6 (37.5) | |
2–5 | 39 (45.3) | 35 (50.0) | 4 (25.0) | |
6+ | 25 (29.1) | 19 (27.1) | 6 (37.5) | |
Any Comorbidities (yes) | 60 (69.8) | 49 (70.0) | 11 (68.8) | 1.00 |
Over the Past 7 Days, How Many Times Did You Miss a Dose of Your CML Medication? | ||||
---|---|---|---|---|
Overall n = 86 n (%) | 0 Times n = 70 n (%) | ≥1 Times n = 16 n (%) | p-Value | |
Single Item adherence measures | ||||
Last 4 weeks, ability to take CML medication | 0.003 * | |||
Excellent | 72 (83.7) | 63 (90.0) | 9 (56.3) | |
Non-Excellent | 14 (16.3) | 7 (10.0) | 7 (43.8) | |
Brief Medication Questionnaire (BMQ) | ||||
Nonadherence (missed taking any pills) | 15 (17.9) | 1 (1.5) | 14 (93.3) | <0.001 * |
Medication Belief (how well does medication work for you—not well, NA or Do medications bother you—yes) | 37 (43.0) | 29 (41.4) | 8 (50.0) | 0.53 |
Recall (remember to take pill (Very hard, somewhat hard) or multi-dose—yes) | 21 (24.4) | 13 (18.6) | 8 (50.0) | 0.008 * |
Rapid Estimate of Adult Literacy in Medicine short form (REALM-SF) | 0.35 | |||
Adequate (7) | 67 (77.9) | 56 (80.0) | 11 (68.8) | |
Moderate (4–6) | 16 (18.6) | 11 (15.7) | 5 (31.3) | |
Low (0–3) | 3 (3.5) | 3 (4.3) | 0 (0) | |
Medications Adherence Reasons Scale (MARS) Form | ||||
Experienced Side effects from this medication | 16 (18.6) | 8 (11.4) | 8 (50.0) | 0.001 * |
Did not have the money to pay for the medicine | 7 (8.1) | 6 (8.6) | 1 (6.3) | 1.00 |
Have concerns about possible side effects from this medicine | 4 (4.7) | 3 (4.3) | 1 (6.3) | 0.57 |
Have concerns about long term effects from this medicine | 8 (9.3) | 5 (7.1) | 3 (18.8) | 0.16 |
Did not have the medicine because the pharmacy was out | 4 (4.7) | 4 (5.7) | 0 (0) | 1.00 |
Have trouble managing all the medicines I take | 1 (1.2) | 1 (1.4) | 0 (0) | 1.00 |
Would have taken the medicine but simply missed it | 21 (24.4) | 14 (20.0) | 7 (43.8) | 0.06 |
Would have taken it but missed it because of a busy schedule | 8 (9.3) | 2 (2.9) | 6 (37.5) | 0.004 * |
Would have taken it but have problems forgetting things in my daily life | 3 (3.5) | 2 (2.9) | 1 (6.3) | 0.47 |
Last 4 Weeks, Ability to Take CML Medication | ||||
---|---|---|---|---|
Single Item Adherence Measures | Overall n = 86 n (%) | Excellent n = 72 n (%) | Non-Excellent n = 14 n (%) | p-Value |
Race | 0.05 | |||
Non-Hispanic White | 76 (88.4) | 66 (91.7) | 10 (71.4) | |
Non-Hispanic Black | 6 (7.0) | 3 (4.2) | 3 (21.4) | |
Other | 4 (4.7) | 3 (4.2) | 1 (7.1) | |
Over the past 7 days, how many times did you miss a dose of your CML medication | 0.003 * | |||
0 | 70 (81.4) | 63 (87.5) | 7 (50.0) | |
1 | 11 (12.8) | 7 (9.7) | 4 (28.6) | |
2 | 1 (1.1) | 0 (0) | 1 (7.1) | |
3 | 1 (1.1) | 0 (0) | 1 (7.1) | |
7 | 3 (3.5) | 2 (2.8) | 1 (7.1) | |
Over the past 7 days, how many times did you miss a dose of your CML medication | 0.003 * | |||
0 | 70 (81.4) | 63 (87.5) | 7 (50.0) | |
≥1 | 16 (18.6) | 9 (12.5) | 7 (50.0) | |
Brief Medication Questionnaire (BMQ) | ||||
Regimen Screen (miss taking any pills—yes) | 15 (17.4) | 7 (10.0) | 8 (57.1) | <0.001 * |
Belief Screen (how well does medication work for you—not well, NA or Do medications bother you—yes) | 37 (43.0) | 28 (38.9) | 9 (64.3) | 0.08 |
Recall Screen (remember to take pill (Very hard, somewhat hard) or multi-dose—yes) | 21 (24.4) | 16 (22.2) | 5 (35.7) | 0.28 |
Rapid Estimate of Adult Literacy in Medicine short form (REALM-SF) | 1.00 | |||
Adequate (7) | 67 (77.9) | 56 (77.8) | 11 (78.6) | |
Moderate (4–6) | 16 (18.16 | 13 (18.1) | 3 (21.4) | |
Low (0–3) | 3 (3.5) | 3 (4.2) | 0 (0) | |
Medications Adherence Reasons Scale (MARS) Form | ||||
Experienced Side effects from this medication | 16 (18.6) | 13 (18.1) | 3 (21.4) | 0.72 |
Did not have the money to pay for the medicine | 7 (8.1) | 7 (9.7) | 0 (0) | 0.59 |
Do not think I need this medication anymore | 0 (0) | 0 (0) | 0 (0) | N/A |
Do not think this medication is working for me | 0 (0) | 0 (0) | 0 (0) | N/A |
Have concerns about possible side effects from this medicine | 4 (4.7) | 3 (4.2) | 1 (7.1) | 0.52 |
Have concerns about long term effects from this medicine | 8 (9.3) | 7 (9.7) | 1 (7.1) | 1.00 |
Did not have the medicine because the pharmacy was out | 4 (4.7) | 2 (2.8) | 2 (14.3) | 0.12 |
Have trouble managing all the medicines I take | 1 (1.2) | 1 (1.4) | 0 (0) | 1.00 |
Would have taken the medicine but simply missed it | 21 (24.4) | 10 (13.9) | 11 (78.6) | <0.001 * |
Would have taken it but missed it because of a busy schedule | 8 (9.3) | 3 (4.2) | 5 (35.7) | 0.002 * |
Would have taken it but have problems forgetting things in my daily life | 3 (3.5) | 2 (2.8) | 1 (7.1) | 0.42 |
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Davis, T.C.; Arnold, C.L.; Mills, G.; Lesser, G.J.; Brown, W.M.; Schulz, R.; Weaver, K.E.; Pawloski, P.A. Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study. Int. J. Environ. Res. Public Health 2021, 18, 11045. https://doi.org/10.3390/ijerph182111045
Davis TC, Arnold CL, Mills G, Lesser GJ, Brown WM, Schulz R, Weaver KE, Pawloski PA. Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study. International Journal of Environmental Research and Public Health. 2021; 18(21):11045. https://doi.org/10.3390/ijerph182111045
Chicago/Turabian StyleDavis, Terry C., Connie L. Arnold, Glenn Mills, Glenn J. Lesser, W. Mark Brown, Richard Schulz, Kathryn E. Weaver, and Pamala A. Pawloski. 2021. "Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study" International Journal of Environmental Research and Public Health 18, no. 21: 11045. https://doi.org/10.3390/ijerph182111045