Oral oncolytic initiation reduces medication adherence for comorbid chronic conditions

20 Jun 2020
Oral oncolytic initiation reduces medication adherence for comorbid chronic conditions

Treatment with oral oncolytics may negatively affect adherence to oral therapies for chronic comorbid conditions among patients with chronic myeloid leukaemia, chronic lymphocytic leukaemia/small lymphocytic lymphoma, or multiple myeloma, reveals a study.

Such action requires medication management strategies to help patients adhere to their entire medication regimen, according to the authors.

Following initiation, significant reductions in adherence were seen across the comorbid therapies. The most notable of which was for patients on lipid-lowering agents (10.7–15.6 percent).

In unadjusted difference-in-difference models, consistent and significantly lower reductions in adherence were also noted in patients taking antihypertensive medications (chronic myeloid leukaemia: p=0.03; chronic lymphocytic leukaemia/small lymphocytic lymphoma: p=0.007; multiple myeloma: p=0.09) after oncolytics initiation.

In this study, the authors identified adults diagnosed with and prescribed oral oncolytics for chronic myeloid leukaemia, chronic lymphocytic leukaemia/small lymphocytic lymphoma, or multiple myeloma between 2013 and 2016 and with continuous eligibility 6 months before and after oral oncolytic initiation from the Truven Health MarketScan databases.

Among identified patients, those with pre-existing diabetes, hypertension, and/or hyperlipidaemia with ≥1 fill for oral comorbid therapies were included in the analysis. The proportion of days covered metric were used to measure adherence to oral oncolytics and comorbid therapies.

The authors assessed changes in adherence for comorbid therapies after initiation of an oral oncolytic via Wilcoxon signed-rank tests. Then, they examined the impact of adherence to oral oncolytics on changes in adherence to comorbid therapies using unadjusted difference-in-difference models.

“Oral oncolytics have improved survival in haematological cancers like chronic myeloid leukaemia, chronic lymphocytic leukaemia/small lymphocytic lymphoma, and multiple myeloma,” the authors noted.

J Oncol Pharm Pract 2020;26:835-845