What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Chronic myeloid leukaemia (n=140). Intervention: Type A and Type D personality traits vs. Lower intensity of Type A and Type D traits. Primary outcome: Medication non-adherence (skipping doses during the entire course of treatment) (p=0.020).

January 19, 2023BioPsychoSocial Medicine8 citationsOpen Access

Personality traits favourable for non-adherence to treatment in patients with chronic myeloid leukaemia: role of type A and D personality

ARAnna Rychter JMJoanna Miniszewska JGJoanna Góra‐Tybor

Key Result

In patients with chronic myeloid leukemia, greater intensity of type A personality traits and higher levels of type D negative affectivity were significantly associated with medication non-adherence (p=0.020 for both).

Study Design

Type

Cross-Sectional (n=140)

Multicenter

Structured PICO

Do specific personality traits (Type A, Type D, Big Five) influence medication non-adherence in patients with chronic myeloid leukemia?

Population

140 adult patients with chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors for at least 6 months, assessed for medication adherence and personality traits.

Exposure

Assessment of personality traits (Big Five, Type A, Type D) using NEO-FFI, Framingham Type A Scale, and D-Scale 14

Outcome

Medication non-adherence (skipping doses in the last month or over the entire treatment period) assessed via self-constructed surveypatient reported

Screening for Type A and Type D personality traits (specifically negative affectivity) may help identify CML patients at higher risk for non-adherence to tyrosine kinase inhibitor therapy.

Main Result

p-value: p=0.020

Limitations

Relatively small number of patients, especially in the dasatinib and nilotinib treatment groups
Selection bias as volunteers might be more willing to cooperate with a doctor
Lack of use of a standardized method to assess adherence to recommendations (self-reported)
No objective measurement of compliance such as drug concentration
Lack of monitoring for mental state such as depression or anxiety disorders
Lack of longitudinal analyses
Relatively small number of patients
Selection bias (volunteers may be more cooperative)
Lack of standardized method to assess adherence
No objective measurement of compliance
Lack of monitoring for mental state (e.g., depression/anxiety)

Abstract

BACKGROUND: The introduction of BCR-ABL tyrosine kinase inhibitors (TKIs) to chronic myeloid leukemia (CML) therapy has revolutionized the treatment of this disease. Although regular TKI intake is a prerequisite for successful therapy, it has been shown that a significant proportion of patients are non-compliant. Recently there is growing evidence that personality traits may influenced the tendency for non-adherence to treatment in patients with chronic diseases. As far as we know, such a relationship in patients with CML has not been examined, yet. The aim of our study was to determine if personality traits favor non-adherence to treatment recommendations. We investigated the relationship between five-factor model personality factors (conscientiousness, neuroticism, agreeableness, extraversion, and openness) and medication non-adherence. We also checked if the patients with type A and type D personality, were at higher risk of poor medication adherence. METHODS: The following tools were used: self-constructed survey, the NEO-Five Factor Inventory, the Framingham Type A Scale, the D-Scale 14. The study included 140 CML patients treated with imatinib, dasatinib, or nilotinib. RESULTS: 39% of patients reported skipping at least one dose of medication in the month prior to follow-up visit. 51% admitted to skipping such doses from the start of their treatment to the time at which our assessment was performed. We did not find any relationship between the mean values of the analyzed factors of the Big Five (neuroticism, extraversion, openness, agreeableness, conscientiousness) and adherence. However, our analysis revealed that CML patients who admitted to missing doses of drugs during the entire course of treatment demonstrated greater intensity of type A personality traits (p = 0.020). Regarding both factors of type D personality, it was revealed that higher level of negative affectivity significantly decreased the adherence (p = 0.020). CONCLUSION: The results of our study indicate that screening for type D and A personalities may help to identify patients who are at higher risk of poor medication adherence.

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