Patients’ and healthcare providers’ views regarding dose reduction of tyrosine kinase inhibitors in chronic myeloid leukemia: a qualitative study

Résumé fourni par la source

BACKGROUND: Dose reduction of tyrosine kinase inhibitors (TKIs) in patients with chronic myeloid leukaemia (CML) can reduce side effects and improve quality of life while maintaining treatment effectiveness and reducing costs. OBJECTIVE: This study evaluates the views of both patients with CML and healthcare providers involved in CML care on dose reduction of TKIs. METHODS: A qualitative study with semi-structured interviews via phone or video call was conducted with Dutch adult patients with CML and their healthcare providers. The COM-B model served as a theoretical framework to guide data collection and analysis to understand participants' capability, opportunity, and motivation for dose reduction. An inductive coding approach was utilized to derive themes from the data. RESULTS: Eighteen patients and twelve healthcare providers (haematologists, nurse specialists, and pharmacists) participated, who in general were supportive of dose reduction. Two main themes were identified: (1) willingness and acceptance of dose reduction, which was shaped by participants' beliefs about the use of TKIs, the impact of TKIs on patients' quality of life, and associated hopes, fears and concerns; and (2) needs and preferences regarding dose reduction such as timing, eligibility, practical aspects, and shared-decision making. CONCLUSION: Patients and healthcare providers have positive views on TKI dose reduction to improve the burden of CML treatment. Acceptance is shaped by their beliefs and concerns, while successful implementation depends on addressing practical needs and shared-decision making.

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