Experiences of living with chronic myeloid leukaemia and adhering to tyrosine kinase inhibitors: A thematic synthesis of qualitative studies.
Ann Hewison, Karl Atkin, Dorothy McCaughan and 4 others
PMID 32169687WHAT IT FOUND
People taking long-term oral targeted cancer drugs described missing doses because of side effects, forgetfulness, travel or social events.
Many did not tell clinicians, so problems may stay hidden unless clinicians ask directly.
Key findings
01Patients reported that side effects, forgetfulness, travel and social occasions led them to miss TKI doses, sometimes intentionally and sometimes accidentally.
02Many patients did not tell clinicians about missed doses or side effects, often because they thought symptoms were trivial, did not want to upset clinicians, or felt they could judge for themselves.
03Advice from clinicians was sometimes inconsistent, including reassurance that missing an occasional dose was acceptable, while patients received little guidance on managing side effects or compensating for missed doses.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a synthesis of qualitative studies, so it describes patient experiences and cannot show that any intervention improves adherence or quality of life. The included studies had variable quality, with several graded fair or poor for methods, sampling, analysis or ethics. The search excluded non-English articles and grey literature, and the authors could not fully search them because of time constraints. Access to medication, costs and health systems differed across countries, so advice may not transfer unchanged to every clinic. Only patient data were used from one study that also interviewed practitioners, so clinician perspectives were not synthesised. The synthesis reports 320 patients across 9 studies, but the individual study samples varied, and not all studies reported the TKI type.
Declared interests
The study was supported by Bloodwise (Grant No. 15037), and the authors declared no competing interests.
The easy way to misread this
Do not read this as proof that asking patients about missed doses improves adherence. It reports patient experiences and suggestions, not tested interventions.