Optimizing Patient Treatment Adherence in CML

EP: 1.NCCN Guidelines and Early Response Monitoring in Chronic Myeloid Leukemia

EP: 2.Shifting Therapeutic Urgency and TKI Strategy

EP: 3.Leveraging Trial Data to Guide Frontline TKI Use

EP: 4.Milestones That Matter: Using Molecular and Clinical Benchmarks to Guide CML Therapy

EP: 5.Reconsidering Later-Line Therapies in CML Management

EP: 6.The Pharmacist’s Role in Navigating Toxicity With TKIs

EP: 7.Expanding Pharmacist Roles in CML Care

EP: 8.Barriers to Accessing TKIs in CML

EP: 9.Overcoming Obstacles in CML Care

EP: 10.Gaps in CML Treatment in Underserved Populations

EP: 11.The Pharmacist’s Role in Treatment Evaluation

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EP: 12.Optimizing Patient Treatment Adherence in CML

Optimizing Patient Treatment Adherence in CML

Pharmacists play a crucial role in supporting clinicians and monitoring treatment adherence in chronic myeloid leukemia (CML) patients on long-term tyrosine kinase inhibitor (TKI) therapy. Evidence demonstrates that maintaining adherence to TKI therapy directly impacts patient outcomes, with perfect or near-perfect adherence correlating with higher probability of achieving major molecular response. Pharmacists can significantly improve adherence through patient support, assessment of noncompliance reasons, development of adherence strategies, and patient coaching. Patient interviews are particularly valuable for understanding individual barriers to adherence, enabling targeted interventions to address specific challenges that might otherwise compromise treatment success.

Regular pharmacist touchpoints and visits prove essential for identifying and addressing adherence barriers early. Many centers implement systematic follow-up programs where pharmacists call new TKI patients 2 weeks into therapy to assess both adherence and tolerance. Since CML therapy is typically long term, increased patient contact through calls and visits helps uncover barriers such as insurance loss, adverse effects contributing to nonadherence, or other challenges requiring intervention. Multiple studies support the critical role of pharmacists in improving patient adherence to oral oncology medications, with oncology-trained clinical pharmacists uniquely positioned to monitor lab values, assess adverse effects, and evaluate adherence barriers during routine follow-up visits.

Patient preference and treatment goals are fundamental considerations when initiating CML therapy and selecting TKI regimens. Since all CML therapies are oral agents, patients maintain primary responsibility for their care, making engagement and buy-in critical for success. Pharmacists must address upfront concerns such as medication adherence challenges, recommending once-daily options when appropriate, or selecting therapies compatible with existing conditions like acid reflux. Financial limitations, adverse effect concerns, and special circumstances like family planning goals all influence treatment selection. The availability of multiple frontline CML options creates opportunities for shared decision-making, allowing pharmacists to present various therapeutic choices and collaborate with patients to determine the most suitable long-term treatment approach.