Which Factors Are Linked With Improved Adherence to Oral Chemotherapy?

Improved communication with clinicians may increase the likelihood that patients will adhere to oral chemotherapy, according to a study published in the Journal of Oncology Practice. Adherence was also improved in patients who reported treatment satisfaction and who reported a reduction in the feeling that they burdened others.

Although it is widely known that patients with cancer vastly prefer oral rather than intravenous chemotherapy, adherence rates and factors associated with nonadherence are not well studied.

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To better understand these factors, researchers conducted a prospective, observational, single-group study of 90 patients with chronic myeloid leukemia or metastatic renal cell carcinoma, non-small-cell lung cancer, or breast cancer. Patients were followed for 12 weeks, and adherence was assessed with an electronic pill cap and bottle (Medication Event Monitoring System) and by self-report. Patients also took surveys at baseline and at 12 weeks that measured symptom distress, mood, quality of life, cancer-specific distress, and satisfaction with clinician communication and treatment.

During the 12-week period, measurements by the Medication Event Monitoring System found that patients took an average of approximately 89% of their prescribed oral chemotherapy, with women showing more adherence than men. About 25% of the patients were less than 90% adherent, the study’s authors noted.

Several factors were associated with improved adherence. These factors included improvements in patient symptom distress, fewer depressive symptoms, and better quality of life. In addition, satisfaction with clinician communication and treatment, and a reduced perception of burdening others were linked with improved adherence.

Using a multivariate model, the researchers found that improved treatment satisfaction and reduced perceived burden to others best correlated with adherence.

“Improved satisfaction with clinician communication and treatment was the most robust predictor of better adherence,” the researchers stated. “This finding parallels research highlighting the importance of the patient-clinician relationship, patient-clinician communication, and patient satisfaction with information received.”

—Lauren LeBano

Reference

Jacobs JM, Pensak NA, Sporn NJ, et al. Treatment satisfaction and adherence to oral chemotherapy in patients with cancer [published online ahead of print April 22, 2017]. J Oncol Pract. doi: 10.1200/JOP.2016.019729.