Patient-focused strategies needed to improve adherence to TKI for chronic myeloid leukaemia

Studies examining the impact of strategies to improve treatment adherence to tyrosine kinase inhibitors (TKIs) for chronic myeloid leukaemia have relied on large data sets instead of prospective trials, according to the results of a systematic review. In addition, current studies lack patient-focused interventions.

“Lack of adherence to TKIs is a significant problem resulting in incomplete cytogenetic response and increased mortality in patients with CML,” the authors said. “Few studies have been conducted on interventions to improve adherence.”

This systematic literature review was thus conducted to explore studies assessing the effect of interventions to improve TKI adherence among patients with CML.

The first two authors completed the review based on the guidelines in Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). They identified a total of 2,633 studies conducted between 1908 and 2019 from three databases and examined these for inclusion or exclusion.

Of the studies, only 14 met the eligibility criteria, all of which examined adherence to imatinib, dasatinib, or nilotinib. Ten studies used large data sets (commercial health insurance plans or Surveillance Epidemiology and End Results data) for analysis. A cohort design was used by majority of the studies.

Of note, adherence was defined and measured in many ways, with most studies using 80 percent or greater as adequate adherence. For interventions that did not focus on healthcare costs, a multidisciplinary team approach was utilized.