Clinician Communication, Perceived Burden Critical for Adherence to Oral Chemotherapy

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Patients who reported better clinician communication or an improved satisfaction with their treatment were more likely to be adherent.
Patients who reported better clinician communication or an improved satisfaction with their treatment were more likely to be adherent.

Patients who reported better clinician communication, a reduced sense that they burdened others, or an improved satisfaction with their treatment during the first 12 weeks of oral chemotherapy were more likely to comply with prescribed treatments, according to a prospective observational cohort study published in the Journal of Oncology Practice.1

“Interventions to help patients improve communication with clinicians and reduce [perceived] burden may optimize oral chemotherapy adherence,” the authors reported.

There is a widely-reported patient preference for oral anticancer treatment over intravenous chemotherapy, but adherence rates and risk factors for non-adherence to oral chemotherapy remain poorly understood.

The study followed 90 patients with chronic myeloid leukemia or metastatic kidney, lung, or breast cancer for 12 weeks, with participants completing questionnaires at baseline and at 12-week follow-up meetings. The questionnaires measured mood (including depression symptoms), quality of life, symptom distress, and patient satisfaction both with treatment and communication with their clinicians.

Using an electronic pill cap Medication Event Monitoring System and patient self-reporting, the study team found that on average, patients were adherent to their oral chemotherapy prescriptions 89% of the time. Women were more adherent than men (mean difference 9.6%; P = .039).

“One quarter of the sample was less than 90% adherent” overall, the authors noted.

Adherence was associated with several variables and changes in 2 variables between baseline and 12-week follow-up. Improved symptom distress, depressive symptoms, quality of life, and satisfaction with both treatment and clinician communication all correlated with better treatment adherence.

In multivariate analysis, reduction in perceived burden to others and improvement in treatment satisfaction were the strongest correlates of adherence (P = .03 and P < .001, respectively). Treatment-adherent patients might also be more likely to report better treatment satisfaction, the authors noted.

“Those who reported improvements in perceptions of being understood and respected by their oncologist, being involved in decisions about their health care, possessing the ability to talk to staff when they needed to, and having trust and confidence in their oncologist were more likely to be adherent,” they wrote.

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The findings are consistent with previously reported studies linking communication — and the quality of relationships — between clinicians and patients with patient treatment satisfaction, and tying patient comprehension of their disease and treatment to adherence.

Reference

  1. Jacobs JM, Pensak NA, Sporn NJ, et al. Treatment satisfaction and adherence to oral chemotherapy in patients with cancer. J Oncol Pract. 2017 Apr 11. doi: 10.1200/JOP.2016.019729 [Epub ahead of print]

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