The relationship between medication literacy and skin adverse reactions in non-small-cell lung cancer patients undergoing targeted EGFR-TKI therapy

Abstract

Background High medication literacy is the basis of rational medication application and is essential for the management of severe adverse drug reactions. The objective of the present study was to assess the level of medication literacy and determine the association between medication literacy and skin adverse drug reactions in non-small-cell lung cancer (NSCLC) patients undergoing targeted epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy. Methods This is a cross-sectional study conducted from May to September 2020. In total, 296 NSCLC patients undergoing targeted EGFR-TKI therapy were recruited from hospitals in Henan, China. Structured questionnaires were used to evaluate skin adverse drug reactions and medication literacy. Pearson correlation analysis and binary logistic regression analysis were carried out to identify the correlations between medication literacy and the severity of skin adverse drug reactions in the recruited patients. Results The research sample consisted of 296 patients with a response rate of 92.5%. The mean score of skin adverse drug reactions and the mean score of medication literacy were 1.83 ± 0.91 and 6.54 ± 2.78, respectively. In total, 188 patients (63.5%) were considered to have moderate medication literacy. According to the binary logistic regression analysis, the following factors were associated with severe skin adverse drug reactions: age (B = − 3.929, P = 0.000), sex (B = -4.062, P = 0.000), educational level (B = 2.712, P = 0.002), comorbidity (B = 3.297, P = 0.001), eczema history (B = 2.996, P = 0.001), nutritional status (B = -4.891, P = 0.000), blood interleukin-6 level (B = -2.143, P = 0.013), blood high-sensitivity C-reactive protein level (B = -4.015, P = 0.000), combination of drugs (B = -3.183, P = 0.048) and medication literacy (B = − 1.503, P = 0.000). Subgroup analysis showed that in addition to medication literacy, some other factors including education level, comorbidity, nutritional status, blood interleukin-6 level and combined drug application were common factors that contributed to various adverse skin drug reactions in NSCLC patients under targeted EGFR-TKI therapy. Conclusion The low medication literacy of the investigated NSCLC patients undergoing targeted EGFR-TKI therapy was correlated with a high proportion of severe skin adverse drug reactions. In addition, factors other than medication literacy including education level, comorbidity, nutritional status, blood interleukin-6 level and the combinatorial application of drugs were also related to the severity of various adverse skin drug reactions. A comprehensive and targeted intervention may be beneficial to improve medication literacy and control severe skin adverse drug reactions in NSCLC patients.

Prophylactic treatment of dacomitinib‐induced skin toxicities in epidermal growth factor receptor‐mutated non–small‐cell lung cancer: A multicenter, Phase II trial

“…Moreover, the protracted recovery time from barrier damage is an additional contributory factor for skin disorders manifestation among Asians. 22 Previously reported risk factors for skin toxicity include age, sex, and smoking history, 23,24 but no obvious risk factors were identified in this study.…”

The Mediating Effect of Self-Efficacy on the Relationship Between Medication Literacy and Medication Adherence Among Patients with Type 2 Diabetes

“…Most of the participants had good medication literacy. Compared with the medication literacy of patients with coronary heart disease (4.96±4.68) and patients with small cell lung cancer (6.54±2.78), 41,42 the medication literacy of patients with type 2 diabetes was better than both. The possible reason is that patients with type 2 diabetes are more familiar with injectable medication for diabetes, and the scenario of injectable medication for diabetes is present in the medication literacy assessment scale.…”

Development of a multivariate predictive model for dapsone adverse drug events in people with leprosy under standard WHO multidrug therapy

“…This association has not been reported in other leprosy studies; however, higher educational levels could lead to a better understanding of the occurrence of drug-related symptoms and, thus, increase the probability of a patient reporting the symptoms, as was described recently by Costa et al (2023) [ 28 ]. Other studies have shown that higher educational levels in different diseases could help medication intake and reduce ADEs [ 32 , 33 ].…”