Treatment Satisfaction and Adherence to Oral Chemotherapy in Patients With Cancer

Jacobs, Jamie M.; Pensak, Nicole; Sporn, Nora; MacDonald, James; Lennes, Inga T.; Safren, Steven A.; Pirl, William F.; Temel, Jennifer S.; Greer, Joseph A.

doi:10.1200/jop.2016.019729

Cited by 117 publications

(101 citation statements)

References 59 publications

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“…In addition, those with greater cancer-related symptom severity and interference, worse fatigue, lower satisfaction with treatment and communication with clinicians, higher anxiety and depressive symptoms, and lower perceived social support had worse QoL. Contrary to previous literature showing a positive association between QoL and adherence to cancer therapies, 14,16 these constructs were not related in our sample. Higher anxiety was most strongly related with worse QoL, with even minimal increases in anxiety associated with large and clinically meaningful reductions in QoL.…”

Section: Discussioncontrasting

confidence: 96%

“…Patients with greater symptom distress and interference also tended to have poorer adherence, consistent with recent findings of a study on adherence and symptom distress, 13 and our previous study showing that patients with cancer who reported higher symptom distress over time experienced poorer medication adherence. 16 As the number of patients receiving oral cancer therapies continues to increase, the process for monitoring side effects and managing adherence requires attention. Although patients report preference for oral administration, 3 few studies have compared QoL in patients prescribed oral versus intravenous chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…Although oral therapy is thought to impair QoL less than intravenous treatment, 4 data are lacking with respect to the physical and psychologic symptoms that patients experience, which could negatively impact adherence. Furthermore, a complete understanding of QoL or the correlates of QoL for these patients does not exist, although some literature shows nonadherence is related to greater symptom distress, 13 poorer QoL, 14 lack of social support, 15 lower satisfaction with treatment, 16 and psychologic distress. 15 We sought to describe rates of adherence and characterize the physical and psychologic symptoms of patients prescribed oral therapy.…”

Section: Introductionmentioning

confidence: 99%

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Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life

Jacobs

Ream

Pensak

et al. 2019

Journal of the National Comprehensive Cancer Network

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Background: Oral therapies are increasingly common in oncology care. However, data are lacking regarding the physical and psychologic symptoms patients experience, or how these factors relate to medication adherence and quality of life (QoL). Materials and Methods: From December 2014 through August 2016, a total of 181 adult patients who were prescribed oral targeted therapy or chemotherapy enrolled in a randomized study of adherence and symptom management at Massachusetts General Hospital Cancer Center. Patients completed baseline assessments of adherence with electronic pill cap, QoL, symptom severity, mood, social support, fatigue, and satisfaction with clinicians and treatment. Relationships among these factors were examined using Pearson product-moment correlations and multivariable linear regression. Results: At baseline, the mean electronic pill cap adherence rate showed that patients took 85.57% of their oral therapy. The most commonly reported cancerrelated symptoms were fatigue (88.60%), drowsiness (76.50%), disturbed sleep (68.20%), memory problems (63.10%), and emotional distress (60.80%). Patients who reported greater cancer-related symptom severity had lower adherence (r5 20.20). In a multivariable regression, greater depressive and anxiety symptoms, worse fatigue, less social support, lower satisfaction with clinicians and treatment, and higher symptom burden were associated with worse QoL (F [10, 146]550.53; adjusted R 2 50.77). Anxiety symptoms were most strongly associated with clinically meaningful decrements in QoL (b5 27.10; SE50.22). Conclusions: Patients prescribed oral therapies struggle with adherence, and cancer-related symptom burden is high and related to worse adherence and QoL. Given perceptions that oral therapies are less impairing, these data underscore the strong need to address adherence issues, symptom burden, and QoL for these patients.

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Section: Discussioncontrasting

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life

Jacobs

Ream

Pensak

et al. 2019

Journal of the National Comprehensive Cancer Network

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“…Previous studies have reported that women are more adherent than men. 39 We did not find a gender difference in adherence to capecitabine. Also, we did not find any association between adherence and self-efficacy for chronic disease management.…”

Section: Effectiveness Of Self-managementmentioning

confidence: 49%

<p>Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents</p>

Jiang¹,

Wickersham²,

Zhang³

et al. 2020

PPA

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Purpose: There are growing concerns about patients' adherence to oral anticancer agents (OAAs), and the need for patients to engage in self-management of OAA-related side effects. We assessed associations among adherence, severity of side effects, and effectiveness of self-management of side effects in patients taking capecitabine. Methods: Adherence to capecitabine at 6 weeks was measured by the Medication Event Monitoring System among 50 patients with gastrointestinal cancers. Severity of side effects related to capecitabine and effectiveness of self-management of side effects were captured using the Modified Self-Care Diary at the time of enrollment and weekly for 6 weeks. Spearman's correlation, Mann-Whitney U-tests, and multiple linear regression were conducted, p<0.05. Results: Overall mean adherence rate was 85.4±14.1%. Adherence rate was not significantly correlated to the mean severity of total side effects at any time point and was correlated with the mean effectiveness of self-management of total side effects only at week 2 (rho=0.29, p=0.04). However, adherence rate was associated with the mean severity of one specific side effect, diarrhea, at 6 weeks (rho=0.36, p=0.01) and marginally correlated to the mean effectiveness of self-management of diarrhea at 6 weeks (rho=0.28, p=0.05). Mean severity of diarrhea at 6 weeks was an independent predictor of adherence rate (b=4.97, p=0.01), with the control of age (b=0.52, p=0.002), number of outpatient medications (b=1.12, p=0.007), health literacy (b=2.53, p=0.04), diagnosis of colorectal cancer (b=11.6, p=0.03), and capecitabine in combination with other chemotherapies (b=16.8, p=0.001) in the model. Conclusion: This pilot study suggests ongoing examination of both severity and effectiveness of self-management of side effects in future studies of adherence to OAAs is merited. There is a need for future studies with larger sample sizes that explore the complex relationships among adherence, severity of side effects, and effectiveness of self-management of side effects in OAA therapy.

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“…In addition, a literature review suggests that greater treatment satisfaction is associated with better treatment compliance and improved persistence . Patients with RRMM require long‐term treatment, and those who are satisfied with their treatments are more likely to participate in the management of their disease, adhere to therapy, and achieve the best possible outcomes . Whether convenience impacts adherence in MM needs to be confirmed in future studies.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Factors in Treatment Satisfaction in Patients with Relapsed/Refractory Multiple Myeloma (RRMM)

et al. 2019

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Treatment Satisfaction and Adherence to Oral Chemotherapy in Patients With Cancer

Abstract: Women and patients who reported increased treatment satisfaction and reduced burden to others were more adherent to oral chemotherapy. Interventions that help patients improve communication with clinicians and reduce burden may optimize oral chemotherapy adherence.

Cited by 117 publications

References 59 publications

Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life

Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life

<p>Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents</p>

Patient-Reported Factors in Treatment Satisfaction in Patients with Relapsed/Refractory Multiple Myeloma (RRMM)

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