A review on adherence management in patients on oral cancer therapies

Wood, Leslie

doi:10.1016/j.ejon.2011.10.002

Cited by 82 publications

(82 citation statements)

References 59 publications

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“…Many obstacles have been identified as negatively impacting treatment adherence, including patients' age, polyprescription, treatment complexity and induced constraints as well as socioeconomic issues [12,13]. As treatment abandonment for economic reasons (out-of-the-pocket drug financing) is not relevant in France, we did not evaluate this item.…”

Section: Discussionmentioning

confidence: 99%

Adherence and Patients' Attitudes to Oral Anticancer Drugs: A Prospective Series of 201 Patients Focusing on Targeted Therapies

et al. 2014

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Objectives: Patient adherence is a challenge in oncology and hematology practice. Hormone therapy data in breast cancer suggest insufficient adherence and poor persistence. Limited data are available for targeted therapies (TT) including tyrosine kinase and mammalian target of rapamycin inhibitors. Methods: We performed a prospective survey using a 15-item questionnaire in patients with solid tumors and hematologic malignancies receiving oral anticancer therapy. Treatment duration, setting (adjuvant vs. metastatic), cancer type, age, and comedication were recorded. Results: 201 patients (median age 65.5 years) participated, 102 with TT and 99 with hormone therapy or chemotherapy (HC). The median time of drug intake was 11.0 months. Written information was more frequently given to TT patients (68.6 vs. 23.2%, p < 0.0001). TT and HC patients showed equal adherence to therapy (72.5 vs. 69.6%, p = n.s.) despite TT patients experiencing more side effects (p < 0.0001) and taking more concomitant oral medication (p = 0.0042). Forgotten doses were the leading cause of nonadherence in HC patients (83%, as compared to 54% in the TT group), whereas dose reduction by the patient was higher in the TT group (32 vs. 17%). Conclusions: Despite advances in providing information to patients leading to better adherence among TT patients, efforts towards better patient education are warranted including dedicated staff for monitoring outpatient anticancer oral therapy.

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Section: Discussionmentioning

confidence: 99%

Adherence and Patients' Attitudes to Oral Anticancer Drugs: A Prospective Series of 201 Patients Focusing on Targeted Therapies

et al. 2014

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“…Suboptimal adherence to oral chemotherapy results in poor quality care, presenting a significant public health concern. As oral chemotherapy plays a more prominent role in cancer treatment, it is important to address medication adherence and improve symptom management for patients [10]. …”

Section: Introductionmentioning

confidence: 99%

Mobile Application to Promote Adherence to Oral Chemotherapy and Symptom Management: A Protocol for Design and Development

et al. 2017

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BackgroundOral chemotherapy is increasingly used in place of traditional intravenous chemotherapy to treat patients with cancer. While oral chemotherapy includes benefits such as ease of administration, convenience, and minimization of invasive infusions, patients receive less oversight, support, and symptom monitoring from clinicians. Additionally, adherence is a well-documented challenge for patients with cancer prescribed oral chemotherapy regimens. With the ever-growing presence of smartphones and potential for efficacious behavioral intervention technology, we created a mobile health intervention for medication and symptom management.ObjectiveThe objective of this study was to develop and evaluate the usability and acceptability of a smartphone app to support adherence to oral chemotherapy and symptom management in patients with cancer.MethodsWe used a 5-step development model to create a comprehensive mobile app with theoretically informed content. The research and technical development team worked together to develop and iteratively test the app. In addition to the research team, key stakeholders including patients and family members, oncology clinicians, health care representatives, and practice administrators contributed to the content refinement of the intervention. Patient and family members also participated in alpha and beta testing of the final prototype to assess usability and acceptability before we began the randomized controlled trial.ResultsWe incorporated app components based on the stakeholder feedback we received in focus groups and alpha and beta testing. App components included medication reminders, self-reporting of medication adherence and symptoms, an education library including nutritional information, Fitbit integration, social networking resources, and individually tailored symptom management feedback. We are conducting a randomized controlled trial to determine the effectiveness of the app in improving adherence to oral chemotherapy, quality of life, and burden of symptoms and side effects. At every stage in this trial, we are engaging stakeholders to solicit feedback on our progress and next steps.ConclusionsTo our knowledge, we are the first to describe the development of an app designed for people taking oral chemotherapy. The app addresses many concerns with oral chemotherapy, such as medication adherence and symptom management. Soliciting feedback from stakeholders with broad perspectives and expertise ensured that the app was acceptable and potentially beneficial for patients, caregivers, and clinicians. In our development process, we instantiated 7 of the 8 best practices proposed in a recent review of mobile health app development. Our process demonstrated the importance of effective communication between research groups and technical teams, as well as meticulous planning of technical specifications before development begins. Future efforts should consider incorporating other proven strategies in software, such as gamification, to bolster the impact of mobile health apps. Fo...

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“…Prior research has produced important findings regarding factors which adversely affect adherence in patients receiving oral oncolytics, including a lack of understanding of proper treatment administration, older age, complex dosing regimens, increased drug costs, and side effects [17–19]. However, there is limited data concerning the benefits of customized therapy management programs and whether specialty pharmacies can play a key role by working with physicians to ensure adherence and persistence in cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Impact of pharmacy channel on adherence to oral oncolytics

Stokes¹,

Reyes²,

et al. 2017

BMC Health Serv Res

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BackgroundOral chemotherapy is increasingly prescribed to treat cancer. Despite its benefits, concerns have been raised regarding adherence to therapy. The study objective was to compare and measure adherence, persistence, and abandonment in patients filling prescriptions in traditional retail (TR) versus specialty pharmacy (SP) channels.MethodsUsing a retrospective cohort design, we selected newly treated patients aged ≥18 years with a prescription for erlotinib, capecitabine, or imatinib during 2007–2011 from a Medco population of both United States commercial and Medicare health plans. Patients were classified according to pharmacy channel providing the medication. Abandonment was defined as a reversal following initial approval of the index prescription claim with no additional paid claims for agent within 90 days of reversal. Patients were considered adherent if the proportion of days covered between the date of the first and last oral prescription was ≥80%.ResultsIn our retrospective cohort, 11,972 filled their prescriptions within the SP channel, and 30,394 filled their prescriptions within the TR channels, respectively. The SP channel had the highest proportion of adherent patients compared with TR (71.6% vs. 56.4%, P < .001). Abandonment of the initial prescription was low with overall rates of only 1.7%. In multivariate models controlling for demographic characteristics, index oncolytic, days of supply, and copay, SP channel (relative to TR) was significantly associated with lower rates of abandonment and increased adherence.ConclusionsPharmacy channel may be influential on abandonment and adherence. Lower rates of abandonment and higher rates of adherence were observed among SP patients versus TR.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2373-2) contains supplementary material, which is available to authorized users.

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A review on adherence management in patients on oral cancer therapies

Cited by 82 publications

References 59 publications

Adherence and Patients' Attitudes to Oral Anticancer Drugs: A Prospective Series of 201 Patients Focusing on Targeted Therapies

Adherence and Patients' Attitudes to Oral Anticancer Drugs: A Prospective Series of 201 Patients Focusing on Targeted Therapies

Mobile Application to Promote Adherence to Oral Chemotherapy and Symptom Management: A Protocol for Design and Development

Impact of pharmacy channel on adherence to oral oncolytics

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