A pharmacist-led interprofessional medication adherence program improved adherence to oral anticancer therapies: The OpTAT randomized controlled trial.

Details

Serval ID
serval:BIB_43D02C36CEB4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A pharmacist-led interprofessional medication adherence program improved adherence to oral anticancer therapies: The OpTAT randomized controlled trial.
Journal
PloS one
Author(s)
Bandiera C., Cardoso E., Locatelli I., Zaman K., Diciolla A., Digklia A., Stravodimou A., Cristina V., Aedo-Lopez V., Dolcan A., Sarivalasis A., Bouchaab H., Pasquier J., Dotta-Celio J., Peters S., Wagner D., Csajka C., Schneider M.P.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2024
Peer-reviewed
Oui
Volume
19
Number
6
Pages
e0304573
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial
Publication Status: epublish
Abstract
Oral anticancer therapies such as protein kinase inhibitors (PKIs) are increasingly prescribed in cancer care. We aimed to evaluate the impact of a pharmacist-led interprofessional medication adherence program (IMAP) on patient implementation (dosing history), persistence (time until premature cessation of the treatment) and adherence to 27 PKIs prescribed for various solid cancers, as well as the impact on patients' beliefs about medicines (BAM) and quality of life (QoL).
Patients (n = 118) were randomized 1:1 into two arms. In the intervention arm, pharmacists supported patient adherence through monthly electronic and motivational feedback, including educational, behavioral and affective components, for 12 months. The control arm received standard care plus EM without intervention. All PKIs were delivered in electronic monitors (EMs). Medication implementation and adherence were compared between groups using generalized estimating equation models, in which relevant covariables were included; persistence was compared with Kaplan‒Meier curves. Information on all treatment interruptions was compiled for the analysis. Questionnaires to evaluate BAM and QoL were completed among patients who refused and those who accepted to participate at inclusion, 6 and 12 months post-inclusion or at study exit.
Day-by-day PKI implementation was consistently higher and statistically significant in the intervention arm (n = 58) than in the control arm (n = 60), with 98.1% and 95.0% (Δ3.1%, 95% confidence interval (CI) of the difference 2.5%; 3.7%) implementation at 6 months, respectively. The probabilities of persistence and adherence were not different between groups, and no difference was found between groups for BAM and QoL scores. No difference in BAM or QoL was found among patients who refused versus those who participated. The intervention benefited mostly men (at 6 months, Δ4.7%, 95% CI 3.4%; 6.0%), those younger than 60 years (Δ4.0%, 95% CI 3.1%; 4.9%), those who had initiated PKI more than 60 days ago before inclusion (Δ4.5%, 95% CI 3.6%; 5.4%), patients without metastasis (Δ4.5%, 95% CI 3.4%; 5.7%), those who were diagnosed with metastasis more than 2 years ago (Δ5.3%, 95% CI 4.3%; 6.4%) and those who had never used any adherence tool before inclusion (Δ3.8%, 95% CI 3.1%; 4.5%).
The IMAP, led by pharmacists in the context of an interprofessional collaborative practice, supported adherence, specifically implementation, to PKIs among patients with solid cancers. To manage adverse drug events, PKI transient interruptions are often mandated as part of a strategy for treatment and adherence optimization according to guidelines. Implementation of longer-term medication adherence interventions in the daily clinic may contribute to the improvement of progression-free survival.
ClinicalTrials.gov NCT04484064.
Keywords
Humans, Female, Male, Medication Adherence, Pharmacists, Middle Aged, Aged, Antineoplastic Agents/therapeutic use, Antineoplastic Agents/administration & dosage, Quality of Life, Administration, Oral, Neoplasms/drug therapy, Protein Kinase Inhibitors/therapeutic use, Protein Kinase Inhibitors/administration & dosage
Pubmed
Web of science
Open Access
Yes
Create date
10/06/2024 10:00
Last modification date
03/07/2024 6:59
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