TY - JOUR
T1 - Adherence to Lenalidomide in Older Adults With Newly Diagnosed Multiple Myeloma
AU - Mian, Hira
AU - Fiala, Mark
AU - Wildes, Tanya M.
N1 - Funding Information:
Supported in part by the National Cancer Institute at the National Institutes of Health (NIH) by grant K12CA167540; its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Research Resources or the NIH. The Center for Administrative Data Research is supported in part by Washington University Institute of Clinical and Translational Sciences grant UL1 TR002345 from the National Center for Advancing Translational Sciences of the NIH and grant R24 HS19455 through the Agency for Healthcare Research and Quality. This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services Inc; and the SEER Program tumor registries in the creation of the SEER-Medicare database.
Funding Information:
Supported in part by the National Cancer Institute at the National Institutes of Health (NIH) by grant K12CA167540 ; its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Research Resources or the NIH. The Center for Administrative Data Research is supported in part by Washington University Institute of Clinical and Translational Sciences grant UL1 TR002345 from the National Center for Advancing Translational Sciences of the NIH and grant R24 HS19455 through the Agency for Healthcare Research and Quality . This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development and Information, Centers for Medicare & Medicaid Services; Information Management Services Inc; and the SEER Program tumor registries in the creation of the SEER-Medicare database.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/2
Y1 - 2020/2
N2 - Introduction: One of the most common orally administered antimyeloma agents, lenalidomide, has significantly improved outcomes in multiple myeloma, including in older patients. However, despite its utilization and cost, the rates and factors related to adherence to lenalidomide in older adults with newly diagnosed multiple myeloma remain unknown. Patients and Methods: Data were collected from adults with newly diagnosed multiple myeloma over age 65 years being treated with lenalidomide therapy between the years 2007 and 2014 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Adherence was measured as medication possession ratio (MPR), which was defined as the ratio of the number of days the patient had pills in their possession to the number of days in the observation period in the first year after myeloma diagnosis. MPR of < 90% was considered poor adherence. Results: A total of 793 patients were included in the analysis. The mean MPR in our cohort was 89.5 ± 9.3%. Overall, 38% (n = 302) of the patients were considered to have poor adherence. Factors associated with poor adherence included increasing age (adjusted odds ratio [aOR] = 1.03 per year; 95% confidence interval [CI], 1.00-1.05; P = .024), black race (aOR = 1.72; 95% CI, 1.08-2.73; P = .022), and polypharmacy (aOR = 1.04 per medication; 95% CI, 1.01-1.08; P = .008). Conclusion: Over a third of older adults with newly diagnosed multiple myeloma were considered to have poor adherence to lenalidomide, using the MPR as a surrogate for adherence. This highlights the need to further understand factors and devise strategies to support adherence in this patient cohort.
AB - Introduction: One of the most common orally administered antimyeloma agents, lenalidomide, has significantly improved outcomes in multiple myeloma, including in older patients. However, despite its utilization and cost, the rates and factors related to adherence to lenalidomide in older adults with newly diagnosed multiple myeloma remain unknown. Patients and Methods: Data were collected from adults with newly diagnosed multiple myeloma over age 65 years being treated with lenalidomide therapy between the years 2007 and 2014 in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Adherence was measured as medication possession ratio (MPR), which was defined as the ratio of the number of days the patient had pills in their possession to the number of days in the observation period in the first year after myeloma diagnosis. MPR of < 90% was considered poor adherence. Results: A total of 793 patients were included in the analysis. The mean MPR in our cohort was 89.5 ± 9.3%. Overall, 38% (n = 302) of the patients were considered to have poor adherence. Factors associated with poor adherence included increasing age (adjusted odds ratio [aOR] = 1.03 per year; 95% confidence interval [CI], 1.00-1.05; P = .024), black race (aOR = 1.72; 95% CI, 1.08-2.73; P = .022), and polypharmacy (aOR = 1.04 per medication; 95% CI, 1.01-1.08; P = .008). Conclusion: Over a third of older adults with newly diagnosed multiple myeloma were considered to have poor adherence to lenalidomide, using the MPR as a surrogate for adherence. This highlights the need to further understand factors and devise strategies to support adherence in this patient cohort.
KW - Adherence
KW - Aged
KW - Geriatric assessment
KW - Multiple Myeloma
KW - Polypharmacy
UR - http://www.scopus.com/inward/record.url?scp=85076516154&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2019.09.618
DO - 10.1016/j.clml.2019.09.618
M3 - Article
C2 - 31843543
AN - SCOPUS:85076516154
VL - 20
SP - 98-104.e1
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
SN - 2152-2650
IS - 2
ER -