Physicians’ influence on breast cancer patient compliance

Kostev, Karel; Waehlert, Lilia; Jockwig, Achim; Jockwig, Barbara; Hadji, Peyman

doi:10.3205/000188

Cited by 8 publications

(7 citation statements)

References 24 publications

(26 reference statements)

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“…Patient factors that lead to treatment nonadherence are viewed separately from physician influences—although the two concepts often coexist. A direct measure of the physician’s influence is seen in a European study concerning non-persistence and treatment discontinuation in breast cancer patients [ 33 ]. This study found that clinics with a poor patient treatment compliance record have a 60% higher chance of patients discontinuing treatment than those with a good compliance record [ 33 ].…”

Section: Rationalementioning

confidence: 99%

“…A direct measure of the physician’s influence is seen in a European study concerning non-persistence and treatment discontinuation in breast cancer patients [ 33 ]. This study found that clinics with a poor patient treatment compliance record have a 60% higher chance of patients discontinuing treatment than those with a good compliance record [ 33 ]. It was also reported that patients exhibit poorer compliance with GP’s than medical specialists.…”

Section: Rationalementioning

confidence: 99%

“…It was also reported that patients exhibit poorer compliance with GP’s than medical specialists. This was possibly due to a greater frequency of visits and stronger relationships formed with the specialists [ 33 ]. A report into patients with prostate cancer found that ‘failure of the clinical team to respond to men’s changing needs was indicated by more than two-thirds of participants as a reason for opting out’ [ 34 , p.2733].…”

Section: Rationalementioning

confidence: 99%

“…The impact of relationships upon patient cooperation and treatment adherence can be significant as demonstrated in various studies [ 33 , 56 ]. Uncertain patients may require a stronger relationship to follow recommendations.…”

Section: Concordancementioning

confidence: 99%

“…For instance, ‘ when oncologists discuss clinical trials in a communication style that is informative, warm, responsive, and caring, patients are more likely to agree to join the trial ‘ [ 81 , p.2]. One study describes communication as frequently underperforming and identified a ‘disturbed equilibrium in the doctor-patient relationship’ [ 33 , p.2]. The patients of doctors that practice patient centred behaviour over a long period are more willing to disclose information.…”

Section: Concordancementioning

confidence: 99%

See 4 more Smart Citations

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

2023

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Background Treatment nonadherence in cancer patients remains high with most interventions having had limited success. Most studies omit the multi-factorial aspects of treatment adherence and refer to medication adherence. The behaviour is rarely defined as intentional or unintentional. Aim The aim of this Scoping Review is to increase understanding of modifiable factors in treatment nonadherence through the relationships that physicians have with their patients. This knowledge can help define when treatment nonadherence is intentional or unintentional and can assist in predicting cancer patients at risk of nonadherence and in intervention design. The scoping review provides the basis for method triangulation in two subsequent qualitative studies: 1. Sentiment analysis of online cancer support groups in relation to treatment nonadherence; 2. A qualitative validation survey to refute / or validate claims from this scoping review. Thereafter, framework development for a future (cancer patient) online peer support intervention. Methods A Scoping Review was performed to identify peer reviewed studies that concern treatment / medication nonadherence in cancer patients—published between 2000 to 2021 (and partial 2022). The review was registered in the Prospero database CRD42020210340 and follows the PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Searches. The principles of meta-ethnography are used in a synthesis of qualitative findings that preserve the context of primary data. An aim of meta-ethnography is to identify common and refuted themes across studies. This is not a mixed methods study, but due to a limited qualitativevidence base and to broaden findings, the qualitative elements (author interpretations) found within relevant quantitative studies have been included. Results Of 7510 articles identified, 240 full texts were reviewed with 35 included. These comprise 15 qualitative and 20 quantitative studies. One major theme, that embraces 6 sub themes has emerged: ‘Physician factors can influence patient factors in treatment nonadherence’. The six (6) subthemes are: 1. Suboptimal Communication; 2. The concept of Information differs between Patient and Physician; 3.Inadequate time. 4. The need for Treatment Concordance is vague or missing from concepts; 5. The importance of Trust in the physician / patient relationship is understated in papers; 6. Treatment concordance as a concept is rarely defined and largely missing from studies. Line of argument was drawn Treatment (or medication) nonadherence that is intentional or unintentional is often attributed to patient factors—with far less attention to the potential influence of physician communication factors. The differentation between intentional or unintentional nonadherence is missing from most qualitative and quantitative studies. The holistic inter-dimensional / multi-factorial concept of ‘treatment adherence’ receives scant attention. The main focus is on medication adherence / nonadherence in the singular context. Nonadherence that is unintentional is not necessarily passive behaviour and may overlap with intentional nonadherence. The absence of treatment concordance is a barrier to treatment adherence and is rarely articulated or defined in studies. Conclusion This review demonstrates how cancer patient treatment nonadherence is often a shared outcome. An equal focus on physican and patient factors can increase understanding of the two main types of nonadherence (intentional or unintentional). This differentation should help improve the fundamentals of intervention design.

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Section: Rationalementioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Section: Concordancementioning

confidence: 99%

Section: Concordancementioning

confidence: 99%

See 3 more Smart Citations

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

2023

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Images of the Patient–Physician Relationship Questionnaire (IPPRQ): An Instrument for Analyzing the Way Patients Make Sense of the Relationship with the Physician

Venuleo

Marinaci²,

Savarese³

et al. 2023

Culture in Policy Making: The Symbolic Universes of Social Action

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Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk

Morman

Byrne

Collins

et al. 2017

Journal of Genetic Counseling

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The purpose of this study was to evaluate the utility of a breast cancer risk assessment (BCRA) at the time of screening mammogram. Women whose BCRA indicated a high risk for cancer received a letter with instructions for breast health care and genetic counseling if appropriate. After 6 months this group received surveys to evaluate their risk perception and their recall of, and compliance with, recommendations. We also explored the impact of other variables such as a recommendation for genetic counseling and physician communication with the women. After the BCRA, the majority of high risk women reported no change in their perceived risk of cancer. A woman's perceived risk of cancer after a BCRA was significantly associated with her recall of recommendations for breast health care, but not with compliance. A recommendation for genetic counseling was not significantly related to women's perceived risk of cancer after the BCRA. Ten percent of women who should have obtained genetic counseling actually completed an appointment. Women who discussed their BCRA results with their physicians were more compliant with a six month breast exam with a doctor (53% vs 17%, p = 0.018). Overall, women felt that the BCRA was helpful and did not cause undue stress or anxiety. Although the cohort's compliance with recommendations was suboptimal, physicians' interactions with their patients may have a positive influence on their compliance.

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Physicians’ influence on breast cancer patient compliance

Cited by 8 publications

References 24 publications

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review

Images of the Patient–Physician Relationship Questionnaire (IPPRQ): An Instrument for Analyzing the Way Patients Make Sense of the Relationship with the Physician

Breast Cancer Risk Assessment at the Time of Screening Mammography: Perceptions and Clinical Management Outcomes for Women at High Risk

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