Table 3.
Salient Studies of Adherence to Targeted Oral Anticancer Medications.
| Cancer | # of Patients | Oral Therapy | Adherence Measure | Adherence Definition | Outcome | Study |
|---|---|---|---|---|---|---|
| CML | 267 | Imatinib | MPR | Continuous | 77.7% over 1 year; lower MPR associated with higher cost | Darkow et al., 2007 |
| CML | 169 | Imatinib | BAAS; PC | Number of positive answers out of 4 | 14% perfectly adherent; 32.7% with at least one positive answer over 90 days | Noens et al., 2009 |
| CML | 592 | Imatinib | MPR | Continuous | 79% mean MPR over 12 months with 41% MPR <85% | Wu et al., 2010 |
| CML | 516 | Imatinib | Patients’ clinic records | Interrupt >1 week | 29.6% nonadherence rate; better survival in those adherent (5 year EFS 76.7% vs. 59.8%) | Ganesan et al., 2011 |
| CML | 87 | Imatinib | MEMS x3 months | Continuous | Median adherence=97.6% (range 24–104%); 26% with <90%; 21% ≤85% →18 fold higher rate of losing CCyR | Marin et al., 2010 Ibrahim et al.,2011 |
| CML | 430 | Imatinib | MPR | Continuous | 60% adherent based on 85% threshold. | St. Charles et al., 2009 |
| CML | 328 550 | Nilotinib Dasatinib | MPR from two claims databases | Continuous | Dasatinib users (73.9%) were less adherent than nilotinib (80.0%) users. | Guerin et al., 2012 |
| CML | 53 197 | Nilotinib Dasatinib | MPR from research database | Continuous | Nilotinib users were almost 2× more likely to have poor adherence than dasatinib users. | Yood et al., 2012 |
| NSCLC | 65 | Erlotinib | Self-report, MEMS, plasma erlotinib levels | Continuous | Ongoing | Timmers et al., 2011 |
| NSCLC | 30 | Erlotinib | Self-report | Continuous | Individuals had mostly medium (n=11) to high (n=14) adherence rates. | Lucca et al., 2012 |
| NSCLC | 200 | Erlotinib | BAAS, VAS, PC, missed appointments | Continuous | Disease control was higher in the intervention cohort (63%) compared with control (44%). The number of adverse events and patient-reported adherence were highly correlated (r=0.105; p=0.0001). | Gebbia et al., 2013 |
| RCC | 1080 | Various | MPR from | Continuous | 81% had adherence rates ≥80% | Hess et al., 2011 |
| RCC | 49 | Various | MEMS | Continuous | Adherence=98.9% | Wolter et al., 2012 |
| GIST | 28 | Imatinib | BAAS | No positive answers out of 4 | 24–29% at 90 days | Mazzeo et al., 2011 |
| CML & GIST | ~4,000 | Imatinib | MPR | Continuous | MPR in GIST was 73%. | Tsang et al., 2006 |
Abbreviations: MPR, medication possession ratio; NA, not available; D/C rate, rate of complete medication discontinuation; PC, pill count; BAAS, Basel Assessment of Adherence Scale with Immunosuppressive Medications; MEMS, Medication Event Monitoring System; CCyR, complete cytogenetic response; VAS, Visual Analog Scale.