Adherence to oral antineoplastic agents by cancer patients: definition and literature review

Abstract

Since the 1990s, oral chemotherapy has been gaining ground as cancer treatment. This therapy seems to have few toxic effects and offers patients good quality of life. However, in addition to the fears the therapy might generate in patients, oral treatment raises a new issue, which, until now, has been marginal in this field: therapeutic observance or adherence. We investigated the research into adherence to oral chemotherapy among cancer patients published between 1990 and July 2013. Studies showed considerable diversity in terms of both the definition and measurement of adherence. As well, adherence to antineoplastic therapy is affected by the patient's understanding of the treatment and ability to remember information provided by the physician, treatment length and psychological distress. Our review of the few studies on adherence to anticancer drug treatment raises some questions that could be pursued in future research. In light of our findings, patients should receive 'therapy education' to help them and their support groups better understand the disease and its treatment and to achieve optimal health management and improved treatment effectiveness.

A Systematic Review of Adherence to Oral Antineoplastic Therapies

“…Although several reviews of adherence to oral antineoplastic therapies have been published [8,12,69,70], only a few were based on the systematic reporting criteria per PRISMA guidelines [10,11,68]. Furthermore, we examined observational, retrospective database, cohort, and randomized intervention studies to describe not only rates and correlates of adherence but also empirical efforts to date to improve proper administration of these oral agents.…”

Self-Reported Adherence to Trifluridine and Tipiracil Hydrochloride for Metastatic Colorectal Cancer: A Retrospective Cohort Study

“…Most studies have included heterogeneous target tumor types, regimens, and therapy settings [16]. Adherence with capecitabine is relatively high compared with other oral cancer chemotherapies [17,18]. Some studies have suggested that only one specific group of patients are nonadherent and that adherence-enhancing interventions should be targeted at this group alone [17,19,20,21].…”

A trial examining an advanced practice nurse intervention to promote medication adherence and symptom management in adult cancer patients prescribed oral anti‐cancer agents: study protocol

“…The significance of this study is that it targets a challenging clinical problem among patients with a life-threatening disease, assisting patients to lower symptom severity, improve adherence, and continue their cancer treatment (Bassan et al 2014, Puts et al 2014.…”

“…However, patients are known to experience symptoms from side effects of treatment and miss as much as one-third of the prescribed OA doses required for treatment of the cancer (Spoelstra et al 2013, Bassan et al 2014, Puts et al 2014. Thus, a need exists to test interventions to train patients to self-manage when OAs are prescribed.…”

“…Lack of adherence to OAs is a significant clinical problem that may result in treatment failure, hospitalization, and, in some instances, reduced longevity (Bassan et al 2014, Puts et al 2014, Given et al 2011. In addition, 75% of cancer patients are known to have chronic conditions (Koroukian et al 2006, Smith et al 2008) with self-management burden.…”