4CPS-167 Medication adherence of thrombopoietin receptor agonists in immune thrombocytopenic purpura: identifying barriers, challenges and solutions through patients’ feedback

<h3>Background and Importance</h3> The pharmaceutical interview (PI) is an exchange between a patient and a pharmacist allowing to collect information and to reinforce advice on treatment, prevention, and education. <h3>Aim and Objectives</h3> This study aims to identify barriers to medication adherence through patients feedback in order to develop a targeted interview for patients with immune thrombocytopenic purpura receiving thrombopoietin receptor agonists. The PI intends to enhance medication adherence after conventional hospitalisation at the treatment initiation. <h3>Material and Methods</h3> A questionnaire derived from the SATMED-Q was designed to assess patient satisfaction and knowledge regarding their treatment and condition. Questions were asked during an interview led by a pharmacist either by phone or in person, and lasting approximately 10 minutes. It included 13 open-ended questions addressing six themes: the patient’s treatment, potential adverse effects, perceived effectiveness of the medication, practical aspects of medication intake, medical follow-up, and overall satisfaction. Selected patients were treated with either eltrombopag or romiplostim and more patients will be included in our study. <h3>Results</h3> Thirteen patients were included. Among them, 70% received eltrombopag, and 46% received romiplostim; two patients were treated with both. For those on eltrombopag (n=9), 33% (n=3) experienced adverse effects. However, 89% (n=8) found the medication effective due to an increase in platelet counts. Moreover, 44% reported difficulties related to the methods of administration. For the romiplostim group (n=6), only one patient experienced adverse effects. The treatment was considered effective for 66% (n=4), 50% (n=3) expressed difficulties with subcutaneous injections. Additionally, 46% (n=6) of patients felt they lacked information about the medication upon discharge. The majority (69%) expressed satisfaction, mainly due to perceived effectiveness of the treatment. <h3>Conclusion and Relevance</h3> The questionnaire revealed barriers to adherence, related to administration methods and adverse effects. The PI would provide essential information to improve compliance, complemented by a medication guide to clarify administration and adverse effects. Nearly half of the patients struggled with timing eltrombopag intake around dairy products. For romiplostim, organisational difficulties were reported regarding weekly subcutaneous injections, making self-injection a topic for discussion. This medication guide may be provided at treatment initiation, and a follow-up interview may be scheduled remotely between 3 to 6 months to further promote adherence. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest