Comorbidity Treatment Regimens a Contributor to Nonadherence to Oral Multiple Myeloma Treatment Regimens

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Patients with multiple myeloma (MM) who were already following complex treatment regimens had poor adherence to oral anticancer agents (OAAs), according to a retrospective study. These findings were published in JCO Oncology Practice.

Survival rates for patients with MM have been improving since 2000, largely due to the availability of new therapies. Use of OAAs has shifted treatment compliance toward self-management, which can be difficult for patients with preexisting comorbidities.

To evaluate OAA adherence, data were sourced from the IBM MarketScan Commercial Claims and Encounters database and Medicare beneficiaries Parts A, B, and D. Patients with MM who were managing comorbid conditions were evaluated for treatment compliance. Adherence to OAA and medications for comorbidities were defined as the proportion of days covered (PDC) of 80% or higher.


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The MarketScan (585 patients) and Medicare (1865 patients) populations had OAA adherence rates of 24.1% and 41.8%, respectively.

Among the MarketScan cohort, the nonadherent patients had fewer outpatient visits (mean, 33.7 vs 43.7; P <.001) and higher Elixhauser condition count (mean, 7.0 vs 6.3; P =.012). For the Medicare population, nonadherence associated with higher Elixhauser condition count (mean, 8.1 vs 6.7; P <.001), use of more therapeutic drug classes (mean, 20.2 vs 18.7; P <.001), and higher rates of diabetes (44.5% vs 35.6%; P <.001) and hypertension (95.5% vs 92.9%; P =.019).

Among both the MarketScan and Medicare cohorts, OAA nonadherence was a significant predictor for nonadherence to antihypertensive medications (MarketScan: −5.2%; P =.031; Medicare: −2.5%; P =.013) but not for antidiabetic medications or statins.

A major limitation of this study was that treatment adherence was defined by prescription filling and not by taking the medications.

This study found that among patients with MM, adherence to OAA treatment was problematic. Providers may consider monitoring treatment compliance for OAAs and other comorbid conditions to improve cancer and noncancer outcomes.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.

Reference

Gatwood J, Dashputre A, Rajpurohit A, et al. Medication adherence among adults with comorbid chronic conditions initiating oral anticancer agent therapy for multiple myeloma. JCO Oncol Pract. 2022;OP2200008. doi:10.1200/OP.22.00008

This article originally appeared on Oncology Nurse Advisor



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