Page 63 - Haematologica-April 2018

Myeloproliferative Disorders
Non-adherence to treatment with cytoreductive and/or antithrombotic drugs is frequent and associated with an increased risk of complica- tions in patients with polycythemia vera or essential thrombocythemia (OUEST study)
Ferrata Storti Foundation
Ronan Le Calloch,1,2 Karine Lacut,3,4,5 Christelle Le Gall-Ianotto,6
Emmanuel Nowak,3 Morgane Abiven,3 Adrian Tempescul,2,7 Florence Dalbies,2,7 Jean-Richard Eveillard,2,7 Valérie Ugo,8 Stéphane Giraudier,9 Gaëlle Guillerm,2,7 Eric Lippert,10 Christian Berthou2,7 and Jean-Christophe Ianotto2,4,7
Haematologica 2018 Volume 103(4):607-613
1Service de Médecine Interne-Maladies du Sang-Maladies Infectieuses (MIIS), CHIC de Quimper; 2Fédération Inter Hospitalière d’Immuno–Hématologie de Bretagne Occidentale (FIHBO); 3CIC 1412, INSERM, Brest; 4EA3878 G.E.T.B.O, Université de Bretagne Occidentale, Brest; 5Département de Médecine Interne et Pneumologie, CHRU de Brest; 6Laboratoire Interactions Epitheliums-Neurones, EA 4685, Université de Bretagne Occidentale; 7Service d’Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest; 8Laboratoire d’Hématologie, CHU d’Angers; 9Laboratoire d'Hématologie, Hôpital St-Louis, AP-HP, Paris and 10Laboratoire d’Hématologie, CHRU de Brest and Equipe ECLA, INSERM U1078, Université de Bretagne Occidentale, Brest, France
ABSTRACT
The purpose of this study was to identify the incidence, causes and impact of non-adherence to oral and subcutaneous chronic treatments for patients with polycythemia vera or essential thrombocythemia. Patients receiving cytoreductive drugs for poly- cythemia vera or essential thrombocythemia were recruited at our institution (Observatoire Brestois des Néoplasies Myéloprolifératives reg- istry). They completed a one-shot questionnaire designed by investiga- tors (Etude de l’Observance Thérapeutique et des Effets Secondaires des Traitements study). Data about complications (thrombosis, transforma- tion and death) at any time in the patient’s life (before diagnosis, up until consultation and after the completion of the questionnaire) were collected. Sixty-five (22.7%) of 286 patients reported poor adherence (<90%) to their treatment with cytoreductive drugs and 46/255 /18%) also declared non-adherence to antithrombotic drugs. In total, 85/286 patients (29.7%) declared they did not adhere to their treatment. Missing an intake was rare and was mostly due to forgetfulness espe- cially during occupational travel and holidays. Patients who did not adhere to their treatment were characterized by younger age, living alone, having few medications but a high numbers of pills and deter- mining their own schedule of drug intake. Having experienced throm- bosis or hematologic evolution did not influence the adherence rate. Non-adherence to oral therapy was associated with a higher risk of phenotypic evolution (7.3 versus 1.8%, P=0.05). For patients treated for polycythemia vera or essential thrombocythemia, non-adherence to cytoreductive and/or antithrombotic therapies is frequent and is influ- enced by age, habitus and concomitant treatments, but not by disease history or treatment side effects. Phenotypic evolution seems to be more frequent in the non-adherent group. (ClinicalTrials.gov #NCT02893410, #NCT02897297).
Correspondence:
jean-christophe.ianotto@chu-brest.fr
Received: September 11, 2017. Accepted: December 15, 2017. Pre-published: December 15, 2017.
doi:10.3324/haematol.2017.180448
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/103/4/607
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haematologica | 2018; 103(4)
607
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