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Chronic Myeloid Leukemia, Adherence, Imatinib, Nine Item Morisky Medication Adherence Scale, Patient Health Questionnaire - 9.
Adherence to imatinib(IM) is of utmost importance in patients with chronic myeloid leukemia(CML) to maximise treatment effectiveness. The main objective is to measure adherence to IM & to evaluate individual patient characteristics, personal, treatment related & psychological factors influencing adherence behaviour. Hundred patients receiving IM were analysed for adherence behaviour using 9 item Morisky Medication Adherence Scale (9-MMAS) . Various factors were assessed for their impact on adherence behaviour. These factors were age, gender, duration of treatment, frequency & dosing of treatment, use of tobacco & alcohol, educational qualification,employment status,monthly income, side effects, financial assistance in treatment, social support, knowledge about medicine & disease, concomitant drug burden, polypharmacy, physician patient interaction, patient educational sessions & prevalence of depression. Seventy five percent of patients were found to be adherent. On univariate analysis, prevalence of depression (p<0.000001), moderate severe depression (p<0.000001), concomitant drug burden (p=0.036) & monthly income (p=0.015) were found to be significantly influencing adherence. The final multivariate model retained prevalence of depression with OR= 10.367 (95% CI, 3.112- 34.538) as independent predictor of adherence to therapy. This study suggests that identification & treatment of depression among CML patients may further enhance adherence to IM therapy.
Keywords: Chronic Myeloid Leukemia, Adherence, Imatinib, Nine Item Morisky Medication Adherence Scale, Patient Health Questionnaire -9.
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