Failure mode and effects analysis of medication adherence in patients with chronic myeloid leukemia
| Autor: | Sakiko Mochinaga, Hiromi Yokoo, Masayoshi Egoshi, Hideaki Tokushima, Kazuhisa Hosoya, Akiko Emoto, Shinya Kimura, Naoko Sueoka-Aragane |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Health Knowledge Attitudes Practice medicine.medical_specialty Medication adherence Antineoplastic Agents Medication Adherence Leukemia Myelogenous Chronic BCR-ABL Positive Surveys and Questionnaires hemic and lymphatic diseases Health care medicine Humans In patient Healthcare Failure Mode and Effect Analysis Risk factor Proto-Oncogene Proteins c-abl Intensive care medicine Adverse effect Protein Kinase Inhibitors Aged Aged 80 and over ABL business.industry Myeloid leukemia Hematology General Medicine Middle Aged Treatment efficacy Oncology Female Surgery business |
| Zdroj: | International Journal of Clinical Oncology. 20:1203-1210 |
| ISSN: | 1437-7772 1341-9625 |
| Popis: | Poor adherence to ABL tyrosine kinase inhibitors (ABL TKIs) is associated with reduced treatment efficacy and increased healthcare costs. To examine the hazards associated with poor adherence, we implemented failure mode and effects analysis (FMEA). We surveyed 54 chronic myeloid leukemia (CML) patients treated at Saga University Hospital from October 2012 to May 2014. The survey consisted of items regarding the type of ABL TKI used, adherence to ABL TKIs, the appearance of adverse effects, utilisation of the high cost medical care benefit system, and factors affecting adherence. Four factors that likely affected adherence were identified, including the level of understanding of ABL TKIs treatment outcomes, adverse effects, the high cost of medications, and careless slips in the taking of medicine. Results of the survey were analysed by FMEA. The risk priority number was highest for careless slips in the taking of medicine at 7.0 ± 1.0 (mean ± SEM), followed in descending order by the inadequate understanding of treatment outcomes (4.9 ± 0.6), adverse effects (3.8 ± 0.8), and high medication cost (2.2 ± 0.5). Thus, the prevention of careless slips was the most important factor affecting adherence to ABL TKIs. Contrary to our preoccupation, FMEA revealed that high medication cost was the lowest risk factor for poor adherence. This finding may be attributed to the high utilisation (96.3 %) of the high cost medical care benefit system. These findings suggest that an inadequate medication-taking habit such as careless slips may represent a potential target to improve and maximize adherence in CML patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink