Medication adherence in chronic myeloid leukemia: a hospital pharmacy-level analysis.

Abstract

Objectives: The objective was to evaluate medication adherence levels in patients with chronic myeloid leukaemia (CML) and to identify factors that may undermine adherence.

Methods: This prospective, cross-sectional study was conducted over a 2-month period among ambulatory patients with CML monitored at one of the country's leading hospitals for diagnosing, treating and monitoring CML in Bulgaria.

Results: Among 70 participants, 91.4% showed high medication adherence, with only 1.4% reporting low adherence. No significant differences in adherence between therapy groups (imatinib vs nilotinib, p=0.1830), gender (p=0.0887) or age groups (p=0.8748) were revealed. Education level was associated with adherence, with lower adherence observed in patients with primary education (p<0.0001). Quality of life, measured using utility values (median=0.8770) and visual analogue scale (mean=80), did not significantly differ based on adherence levels, therapy type or education level. Logistic regression showed that men had 1.9 times higher odds of high adherence compared with women (p>0.05). Patients under 65 had 3.3 times higher odds of adherence compared with those over 65 (p>0.05), and those on imatinib had 22.86% of the adherence odds compared with those on nilotinib. The findings suggest that maintaining high medication adherence is crucial for positive therapeutic outcomes in patients with CML.

Conclusion: Patients with CML in Bulgaria show high medication adherence, likely contributing to their overall quality of life. These findings emphasise the importance of maintaining adherence for optimal treatment outcomes in CML. Future research should explore the factors influencing adherence in this population and assess the role of hospital pharmacists in supporting medication management.