Prototype Intervention Increased Adherence to TKIs in CML

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A prototype intervention increased adherence to tyrosine kinase inhibitor therapy in some patients with chronic myeloid leukemia.
A prototype intervention increased adherence to tyrosine kinase inhibitor therapy in some patients with chronic myeloid leukemia.

Patients with chronic myeloid leukemia (CML) who underwent multilevel intervention had greater odds of staying adherent to tyrosine kinase inhibitor (TKI) treatment, the TAKE-IT study reported.1

The pilot trial followed a quasi-experimental pre-post intervention design and included a convenience sample of 58 CML patients who received TKI treatment across 4 different centers in Israel. Patients were aged a median of 60.5 years, and most patients (62%) received TKI treatment in the first-line setting.

Study researchers determined patient adherence to TKIs through electronic monitoring. Patients were electronically monitored for 4 months to determine baseline adherence before intervention and then for 3 months after intervention. The intervention was a multilevel approach, including training of health care providers and use of behavior change techniques with patients, such as motivational interviewing and feedback on electronic monitoring results.

At baseline, patients had a median adherence rate of 97.5% (range, 48%-100%). After intervention, the odds of a patient taking the TKI daily as prescribed were 58% greater compared with baseline (odds ratio = 1.58; 95% confidence interval [CI], 1.16-2.15). Overall, adherence among patients increased by 1.5% (95% CI, 0.1-2.8; P = .04). In a subset of 10 patients who had adherence levels below 90% at baseline, however, adherence increased from a 71.2% average adherence before intervention to an average adherence of 79.6% after intervention, representing an 8.5% increase in adherence (P = .04).

“TKI adherence improved with our pilot intervention, mainly in patients with suboptimal baseline adherence,” the study authors wrote.

Reference

  1. Leader A, Benyamini N, Gafter-Gvili A, et al. Effect of Adherence-enhancing Interventions on Adherence to Tyrosine Kinase Inhibitor Treatment in Chronic Myeloid Leukemia (TAKE-IT): A quasi-experimental pre-post intervention multicenter pilot study. Clin Lymphoma Myeloma Leuk. 2018;18(11):e449-e461. doi: 10.1016/j.clml.2018.06.026

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