Efficacy of a medication management service in improving adherence to tyrosine kinase inhibitors and clinical outcomes of patients with chronic myeloid leukaemia: a randomised controlled trial

Tan, Bee Kim; Chua, Siew Siang; Chen, Li‐Chia; Chang, Kian Meng; Balashanker, Sharmini; Bee, Ping Chong

doi:10.1007/s00520-019-05133-0

Cited by 14 publications

(31 citation statements)

References 31 publications

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“…Participants in the intervention arm (n = 65), who benefited from the pharmacist-led interventions in the present study, showed significantly higher adherence to TKI therapy than participants in the control group (n = 64) at the 6th month of the RCT (81.5% vs 56.3%, p = 0.002). 19…”

Section: Discussionmentioning

confidence: 99%

“…The present study was an analysis of DRPs managed by the pharmacist-led interventions, which were developed and assessed in a randomised controlled trial (RCT), for their effectiveness in improving adherence to TKI therapy and clinical outcomes in CML patients. 19 The RCT was conducted in the haematology clinics of two hospitals; Ampang Hospital (a national referral centre for haematology under the Ministry of Health Malaysia) and University Malaya Medical Centre (a public tertiary teaching hospital). Prior to commencement of the study, ethical approval was obtained from the Medical Research and Ethics Committee of the Ministry of Health Malaysia (Ref.…”

Section: Methodsmentioning

confidence: 99%

“…This medication management service composed of written and verbal educational interventions, counselling of patients and family members, as well as provision of adherence aids. 19 It also involved collaboration with other stakeholders, such as the clinicians, to resolve medication-related issues. The pharmacist identified any pharmaceutical care issues related to patients in the intervention arm and helped to minimise or resolve them.…”

Section: Introductionmentioning

confidence: 99%

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Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia

Tan

Chua

Chen

et al. 2020

J Oncol Pharm Pract

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Purpose Chronic myeloid leukaemia (CML) patients on long-term tyrosine kinase inhibitor (TKI) therapy are susceptible to drug-related problems (DRPs). This study aimed to evaluate the acceptability and outcomes of pharmacist-led interventions on DRPs encountered by CML patients. Methods This study included participants from the intervention arm of a randomised controlled trial which was conducted to evaluate the effects of pharmacist-led interventions on CML patients treated with TKIs. Participants were recruited and followed up in the haematology clinics of two hospitals in Malaysia from March 2017 to January 2019. A pharmacist identified DRPs and helped to resolve them. Patients were followed-up for six months, and their DRPs were assessed based on the Pharmaceutical Care Network Europe Classification for DRP v7.0. The identified DRPs, the pharmacist’s interventions, and the acceptance and outcomes of the interventions were recorded. A Poisson multivariable regression model was used to analyse factors associated with the number of identified DRPs per participant. Results A total of 198 DRPs were identified from 65 CML patients. The median number of DRPs per participants was 3 (interquartile range: 2, 4). Most participants (97%) had at least one DRP, which included adverse drug events (45.5%), treatment ineffectiveness (31.5%) and patients’ treatment concerns or dissatisfaction (23%). The 228 causes of DRPs identified comprised the following: lack of disease or treatment information, or outcome monitoring (47.8%), inappropriate drug use processes (23.2%), inappropriate patient behaviour (19.9%), suboptimal drug selection (6.1%), suboptimal dose selection (2.6%) and logistic issues in dispensing (0.4%). The number of concomitant medications was significantly associated with the number of DRPs (adjusted Odds Ratio: 1.100; 95% CI: 1.005, 1.205; p = 0.040). Overall, 233 interventions were made. These included providing patient education on disease states or TKI-related side effects (75.1%) and recommending appropriate instructions for taking medications (7.7%). Of the 233 interventions, 94.4% were accepted and 83.7% were implemented by the prescriber or patient. A total of 154 DRPs (77.3%) were resolved. Conclusions The pharmacist-led interventions among CML patients managed to identify various DRPs, were well accepted by both TKI prescribers and patients, and had a high success rate of resolving the DRPs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia

Tan

Chua

Chen

et al. 2020

J Oncol Pharm Pract

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“…The majority (5 out of 9) recruited participants from multiple institutions. 27 , 28 , 30 , 32 , 33 Study sample sizes ranged from 23 to 558 participants ( Table 2 ). All included studies assessed complex interventions with several components to ensure CML patients’ effective engagement and optimal adherence to TKIs.…”

Section: Resultsmentioning

confidence: 99%

Monitoring and Improving Adherence to Tyrosine Kinase Inhibitors in Patients with Chronic Myeloid Leukemia: A Systematic Review

Tan¹,

Bee²,

Chua³

et al. 2021

PPA

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“…CML accounts for approximately 15% of new cases of leukemia, with an estimated risk of 1.5 cases per 100,000 people (RYCHTER et al, 2017). Despite the low incidence compared to other types of cancer (lung, prostate, breast), due to imatinib mesilate therapy, patients with CML showed a considerable improvement in the five-year survival rate and modified the prognosis of the disease (TRIVEDI et al, 2014;SAUSSELE et al, 2018;TAN et al, 2019;LATREMOUILLE-VIAU et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Follow-up form for adult patients with leukemia using Imatinib

Sbruzzi¹,

Silva²,

Telles³

et al. 2020

Revista Científica Multidisciplinar Núcleo do Conhecimento

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Introduction: Chronic Myeloid Leukemia is a type of malignant blood neoplasia that is mainly characterized by the presence of the Philadelphia chromosome that originates the oncoprotein BCR-ABL. It has increased tyrosine kinase activity, thus causing changes in intracellular signaling pathways and promoting uncontrolled proliferation, cellular dysfunction and absence of apoptosis. Despite the low incidence of the disease, 1.5 cases per 100,000 inhabitants, therapy with Imatinib, a potent inhibitor of BCR-ABL, changed the prognosis of the disease and extended the life expectancy of patients, transforming a fatal disease into a chronic condition. Objective: To develop a form for regular monitoring of these patients by the clinical pharmacist to ensure safe and effective pharmacotherapy. Methodology: Narrative-type literature review was initiated from the problem question: ‘“What data should be collected by the Clinical Pharmacist during pharmaceutical assistance to assess and improve adherence in adult patients with Chronic Myeloid Leukemia using Imatinib?” , followed by search for articles in PubMed databases and government websites. Subsequently, work selection and critical analysis were carried out to build a model form to be applied in the act of dispensing. Result and Discussion. Eleven articles were selected. The patient’s low adherence to the treatment of chronic myeloid leukemia can result in potentially life-threatening. Therefore, the follow-up form to be applied by the clinical pharmacist when dispensing imatinib mesylate is a viable and low-cost strategy to improve adherence to pharmacotherapy and promote a better response to treatment. Conclusion: The systematic and standardized documentation of adherence and adverse effects by the Clinical pharmacist allows the implementation of actions by the multidisciplinary team of continuous improvements in order to maximize the quality of care provided to patients as well as the quality of life.

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Efficacy of a medication management service in improving adherence to tyrosine kinase inhibitors and clinical outcomes of patients with chronic myeloid leukaemia: a randomised controlled trial

Cited by 14 publications

References 31 publications

Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia

Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia

Monitoring and Improving Adherence to Tyrosine Kinase Inhibitors in Patients with Chronic Myeloid Leukemia: A Systematic Review

Follow-up form for adult patients with leukemia using Imatinib

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