Advertisement

High adherence of patients with multiple myeloma who receive treatment with immunomodulatory drugs (IMIDS) in hematology/oncology group practices in Germany

  • Stefan FeitenEmail author
  • Geothy Chakupurakal
  • Hans Peter Feustel
  • Michael Maasberg
  • Burkhard Otremba
  • Peter Ehscheidt
  • Manfred Hensel
  • Richard Hansen
  • Rudolf Weide
Original Article

Abstract

Purpose

Immunomodulatory drugs (IMIDS) have changed the treatment and outcome of patients suffering from multiple myeloma. However, with the oral administration adherence becomes an issue. Since there is no “gold standard” in measuring adherence, we assessed the adherence of myeloma patients with the help of different data sources.

Methods

All patients who have been receiving IMIDS for at least 3 months were eligible. Computer assisted personal interviews of patients and, if possible, their caregivers were carried out. Attending oncologists evaluated the patient’s adherence with the help of a standardized questionnaire. In addition, a retrospective analysis of prescription data was conducted. All data were analyzed statistically using SPSS.

Results

One hundred myeloma patients, 35% female, 65% male, with a median age of 70 years (37–86) were interviewed. Prescription data could be evaluated in terms of adherence in 78 patients (78%), 56 caregivers could be questioned (56%). Ninety-seven percent of patients rated themselves as adherent in taking IMIDS. Data from treating oncologists, caregivers and prescriptions supported this result. IMID therapies were rated as very effective and significant, toxicities were acceptable and dosing regimens simple/uncomplicated.

Conclusions

Myeloma patients seem to be highly adherent to IMID treatments.

Keywords

Multiple myeloma Adherence Compliance Immunomodulatory drugs IMIDS Outpatient treatment 

Notes

Acknowledgments

Thanks to Vera Friesenhahn and Kristina Kleboth for their support in running this study and to all study nurses who carried out the interviews.

Funding

This work was supported through a restricted grant from Celgene GmbH, Germany. Celgene had no role in gathering, analyzing, or interpreting the data.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Palumbo A, Mina R (2013) Management of older adults with multiple myeloma. Blood Rev 27(3):133–142.  https://doi.org/10.1016/j.blre.2013.04.001 CrossRefPubMedGoogle Scholar
  2. 2.
    Rajan AM, Kumar S (2016) New investigational drugs with single-agent activity in multiple myeloma. Blood Cancer J 6(7):e451.  https://doi.org/10.1038/bcj.2016.53 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Palumbo A, Anderson K (2011) Multiple myeloma. N Engl J Med 364(11):1046–1060.  https://doi.org/10.1056/NEJMra1011442 CrossRefPubMedGoogle Scholar
  4. 4.
    Mathes T, Jaschinski T, Pieper D (2014) Adherence influencing factors - a systematic review of systematic reviews. Arch Public Health 72(1):37.  https://doi.org/10.1186/2049-3258-72-37 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    McCowan C, Shearer J, Donnan PT, Dewar JA, Crilly M, Thompson AM, Fahey TP (2008) Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br J Cancer 99(11):1763–1768.  https://doi.org/10.1038/sj.bjc.6604758 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Ibrahim AR, Eliasson L, Apperley JF, Milojkovic D, Bua M, Szydlo R, Mahon FX, Kozlowski K, Paliompeis C, Foroni L, Khorashad JS, Bazeos A, Molimard M, Reid A, Rezvani K, Gerrard G, Goldman J, Marin D (2011) Poor adherence is the main reason for loss of CCyR and imatinib failure for chronic myeloid leukemia patients on long-term therapy. Blood 117(14):3733–3736.  https://doi.org/10.1182/blood-2010-10-309807 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Marin D, Bazeos A, Mahon FX, Eliasson L, Milojkovic D, Bua M, Apperley JF, Szydlo R, Desai R, Kozlowski K, Paliompeis C, Latham V, Foroni L, Molimard M, Reid A, Rezvani K, de Lavallade H, Guallar C, Goldman J, Khorashad JS (2010) Adherence is the critical factor for achieving molecular responses in patients with chronic myeloid leukemia who achieve complete cytogenetic responses on imatinib. J Clin Oncol 28(14):2381–2388.  https://doi.org/10.1200/jco.2009.26.3087 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Al-Barrak J, Cheung WY (2013) Adherence to imatinib therapy in gastrointestinal stromal tumors and chronic myeloid leukemia. Support Care Cancer 21(8):2351–2357.  https://doi.org/10.1007/s00520-013-1831-6 CrossRefPubMedGoogle Scholar
  9. 9.
    Greer JA, Amoyal N, Nisotel L, Fishbein JN, MacDonald J, Stagl J, Lennes I, Temel JS, Safren SA, Pirl WF (2016) A systematic review of adherence to oral antineoplastic therapies. Oncologist 21(3):354–376.  https://doi.org/10.1634/theoncologist.2015-0405 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Ruddy K, Mayer E, Partridge A (2009) Patient adherence and persistence with oral anticancer treatment. CA Cancer J Clin 59(1):56–66.  https://doi.org/10.3322/caac.20004 CrossRefPubMedGoogle Scholar
  11. 11.
    Cramer JA, Roy A, Burrell A, Fairchild CJ, Fuldeore MJ, Ollendorf DA, Wong PK (2008) Medication compliance and persistence: terminology and definitions. Value Health 11(1):44–47.  https://doi.org/10.1111/j.1524-4733.2007.00213.x CrossRefPubMedGoogle Scholar
  12. 12.
    Hohneker J, Shah-Mehta S, Brandt PS (2011) Perspectives on adherence and persistence with oral medications for cancer treatment. J Oncol Pract 7(1):65–67.  https://doi.org/10.1200/JOP.2010.000076 CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Foulon V, Schoffski P, Wolter P (2011) Patient adherence to oral anticancer drugs: an emerging issue in modern oncology. Acta Clin Belg 66(2):85–96.  https://doi.org/10.2143/ACB.66.2.2062525 CrossRefPubMedGoogle Scholar
  14. 14.
    Grymonpre R, Cheang M, Fraser M, Metge C, Sitar DS (2006) Validity of a prescription claims database to estimate medication adherence in older persons. Med Care 44(5):471–477.  https://doi.org/10.1097/01.mlr.0000207817.32496.cb CrossRefPubMedGoogle Scholar
  15. 15.
    Vermeire E, Hearnshaw H, Van Royen P, Denekens J (2001) Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Ther 26(5):331–342CrossRefGoogle Scholar
  16. 16.
    Banning M (2008) Older people and adherence with medication: a review of the literature. Int J Nurs Stud 45(10):1550–1561.  https://doi.org/10.1016/j.ijnurstu.2008.02.009 CrossRefPubMedGoogle Scholar
  17. 17.
    Banning M (2012) Adherence to adjuvant therapy in post-menopausal breast cancer patients: a review. Eur J Cancer Care 21(1):10–19.  https://doi.org/10.1111/j.1365-2354.2011.01295.x CrossRefGoogle Scholar
  18. 18.
    Waterhouse DM, Calzone KA, Mele C, Brenner DE (1993) Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring. J Clin Oncol 11(6):1189–1197.  https://doi.org/10.1200/jco.1993.11.6.1189 CrossRefPubMedGoogle Scholar
  19. 19.
    Escalada P, Griffiths P (2006) Do people with cancer comply with oral chemotherapy treatments? Br J Community Nurs 11(12):532–536.  https://doi.org/10.12968/bjcn.2006.11.12.22424 CrossRefPubMedGoogle Scholar
  20. 20.
    Mislang AR, Wildes TM, Kanesvaran R, Baldini C, Holmes HM, Nightingale G, Coolbrandt A, Biganzoli L (2017) Adherence to oral cancer therapy in older adults: the International Society of Geriatric Oncology (SIOG) taskforce recommendations. Cancer Treat Rev 57:58–66.  https://doi.org/10.1016/j.ctrv.2017.05.002 CrossRefPubMedGoogle Scholar
  21. 21.
    Palmieri FM, Barton DL (2007) Challenges of oral medications in patients with advanced breast cancer. Semin Oncol Nurs 23(4 Suppl 2):S17–S22.  https://doi.org/10.1016/j.soncn.2007.10.004 CrossRefPubMedGoogle Scholar
  22. 22.
    Wang PS, Benner JS, Glynn RJ, Winkelmayer WC, Mogun H, Avorn J (2004) How well do patients report noncompliance with antihypertensive medications?: a comparison of self-report versus filled prescriptions. Pharmacoepidemiol Drug Saf 13(1):11–19.  https://doi.org/10.1002/pds.819 CrossRefPubMedGoogle Scholar
  23. 23.
    Figueiredo Junior AG, Forones NM (2014) Study on adherence to capecitabine among patients with colorectal cancer and metastatic breast cancer. Arq Gastroenterol 51(3):186–191CrossRefPubMedGoogle Scholar
  24. 24.
    Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353(5):487–497.  https://doi.org/10.1056/NEJMra050100 CrossRefPubMedGoogle Scholar
  25. 25.
    Zahrina AK, Norsa'adah B, Hassan NB, Norazwany Y, Norhayati I, Roslan MH, Wan Nazuha WR (2014) Adherence to capecitabine treatment and contributing factors among cancer patients in Malaysia. Asian Pac J Cancer Prev 15(21):9225–9232CrossRefPubMedGoogle Scholar
  26. 26.
    Feiten S, Weide R, Friesenhahn V, Heymanns J, Kleboth K, Koppler H, van Roye C, Thomalla J (2016) Adherence assessment of patients with metastatic solid tumors who are treated in an oncology group practice. SpringerPlus 5:270.  https://doi.org/10.1186/s40064-016-1851-z CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310CrossRefPubMedGoogle Scholar
  28. 28.
    Kwiecien R, Kopp-Schneider A, Blettner M (2011) Concordance analysis: part 16 of a series on evaluation of scientific publications. Dtsch Arztebl Int 108(30):515–521.  https://doi.org/10.3238/arztebl.2011.0515 CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    Baumann W, Welslau M (2017) Patientenadhärenz in der oralen medizinischen Onkologie. Onkologe 23:645–650.  https://doi.org/10.1007/s00761-017-0237-3 CrossRefGoogle Scholar
  30. 30.
    Ziller V, Kalder M, Albert US, Holzhauer W, Ziller M, Wagner U, Hadji P (2009) Adherence to adjuvant endocrine therapy in postmenopausal women with breast cancer. Annals of oncology: official journal of the European society for. Med Oncol 20(3):431–436.  https://doi.org/10.1093/annonc/mdn646 CrossRefGoogle Scholar
  31. 31.
    Winterhalder R, Hoesli P, Delmore G, Pederiva S, Bressoud A, Hermann F, von Moos R (2011) Self-reported compliance with capecitabine: findings from a prospective cohort analysis. Oncology 80(1–2):29–33.  https://doi.org/10.1159/000328317 CrossRefPubMedGoogle Scholar
  32. 32.
    Smith AD, Olson C, Lyons B, Tran D, Blackburn DF (2015) Adherence to abiraterone among the first 86 recipients after release in Saskatchewan. Curr Oncol 22(1):64–67.  https://doi.org/10.3747/co.22.2219 CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Timmers L, Boons CC, Moes-Ten Hove J, Smit EF, van de Ven PM, Aerts JG, Swart EL, Boven E, Hugtenburg JG (2015) Adherence, exposure and patients’ experiences with the use of erlotinib in non-small cell lung cancer. J Cancer Res Clin Oncol 141(8):1481–1491.  https://doi.org/10.1007/s00432-015-1935-0 CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Arber A, Odelius A, Williams P, Lemanska A, Faithfull S (2017) Do patients on oral chemotherapy have sufficient knowledge for optimal adherence? A mixed methods study. Eur J Cancer Care 26(2).  https://doi.org/10.1111/ecc.12413
  35. 35.
    Timmers L, Boons CC, Kropff F, van de Ven PM, Swart EL, Smit EF, Zweegman S, Kroep JR, Timmer-Bonte JN, Boven E, Hugtenburg JG (2014) Adherence and patients’ experiences with the use of oral anticancer agents. Acta Oncol (Stockh) 53(2):259–267.  https://doi.org/10.3109/0284186x.2013.844353 CrossRefGoogle Scholar
  36. 36.
    Sharma M, Loh KP, Nightingale G, Mohile SG, Holmes HM (2016) Polypharmacy and potentially inappropriate medication use in geriatric oncology. J Geriatr Oncol 7(5):346–353.  https://doi.org/10.1016/j.jgo.2016.07.010 CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Simons S, Ringsdorf S, Braun M, Mey UJ, Schwindt PF, Ko YD, Schmidt-Wolf I, Kuhn W, Jaehde U (2011) Enhancing adherence to capecitabine chemotherapy by means of multidisciplinary pharmaceutical care. Support Care Cancer 19(7):1009–1018.  https://doi.org/10.1007/s00520-010-0927-5 CrossRefPubMedGoogle Scholar
  38. 38.
    Schneider SM, Adams DB, Gosselin T (2014) A tailored nurse coaching intervention for oral chemotherapy adherence. J Adv Pract Oncol 5(3):163–172PubMedPubMedCentralGoogle Scholar
  39. 39.
    Chari A, Bhor M, Eldjerou L, Gilligan AM, Urniasz A, Globe D, Stetsovsky D, Varker H, Davis B, Bonafede M, Talcott J (2018) Treatment patterns and medication adherence among patients diagnosed with multiple myeloma and treated with panobinostat. Future Oncol.  https://doi.org/10.2217/fon-2017-0727
  40. 40.
    Cransac ASB, Marty-Quinternet S, Pernot C, Caillot D, Boulin M (2017) DI-053 adherence to immunomodulatory drugs in patients with multiple myeloma. Eur J Hosp Pharm 24:A136–A137Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Stefan Feiten
    • 1
    Email author
  • Geothy Chakupurakal
    • 2
  • Hans Peter Feustel
    • 3
  • Michael Maasberg
    • 4
  • Burkhard Otremba
    • 5
  • Peter Ehscheidt
    • 6
  • Manfred Hensel
    • 7
  • Richard Hansen
    • 8
  • Rudolf Weide
    • 2
  1. 1.Institut für Versorgungsforschung in der OnkologieKoblenzGermany
  2. 2.Praxisklinik für Hämatologie und OnkologieKoblenzGermany
  3. 3.Onkologische SchwerpunktpraxisSpeyerGermany
  4. 4.Onkologische GemeinschaftspraxisMayenGermany
  5. 5.Onkologische PraxisOldenburg/DelmenhorstGermany
  6. 6.Onkologische Praxis Dr. EhscheidtNeuwiedGermany
  7. 7.Mannheimer Onkologie PraxisMannheimGermany
  8. 8.Onkologische SchwerpunktpraxisKaiserslauternGermany

Personalised recommendations