Assessment of patients’ understanding of and adherence to oral anticancer medication (OAM): Results of a cross-sectional institutional pilot study

Abstract

Background Although oral anticancer medications (OAM) provide opportunity for treatment at home, challenges include prescription filling, monitoring side effects, safe handling, and adherence. We assessed understanding of and adherence to OAM in vulnerable patients. Methods This 2018 pilot study defined vulnerable patients based on Chinese language, older age (≥65 years), and subsidized insurance. All participants had a cancer diagnosis and were taking an OAM filled through the hospital’s specialty pharmacy. Participants reported on OAM taking (days per week, times per day, special instructions) and handling (handling, storage, disposal). The specialty pharmacist classified patient-reported responses about OAM taking and handling as adequate or inadequate. OAM regimens were classified by complexity. Results Of 61 eligible patients, 55 participated. Mean age was 68 years (standard deviation [SD] = 12) and 53% were female. Patient subgroups were: 27% Chinese, 64% ≥65 years, and 9% subsidized insurance. Forty-nine percent were on frontline therapy and median time on OAM was 1 year (Quartile 1 = 0.4, Quartile 3 = 1.7). Adequacy of OAM taking (30%) and handling (15%) were low; 15% had adequacy in both. Adequacy of OAM taking and handling did not vary by patient subgroup or regimen complexity. Mean patient-reported adherence was high (5.4, SD = 1, possible range 1–6) and did not vary by adequacy of OAM taking or handling. Conclusions Understanding of OAM taking and handling in this group of vulnerable patients was low and did not align with patient-reported adherence. Future interventions should ensure that patients understand how to safely take and handle OAM, thereby optimizing their therapeutic potential.

Satisfaction of Cancer Patients Treated with Oral Anticancer Medications regarding Dispensing by Community Pharmacists: A Cross-Sectional Study

“…Tis number seems high knowing that adherence to long-term therapy for chronic illnesses in developed countries is about 50% [31]. However, other studies obtained results similar to our study, with a high level of medication adherence or compliance to OAMs (compliance to capecitabine: 91% [32], score of adherence to OAMs: 5.4 ± 1 based on a score ranging from 1 to 6 [33], and adherence to OAMs: >80% [34], 78% [35], and 71-73% [36]). Tis high adherence to OAMs can be explained in particular by the gravity of the cancer [32].…”

Enhancing patients’ understanding of and adherence to oral anticancer medication: Results of a longitudinal pilot intervention

“…To address these challenges we designed a pilot crosssectional assessment of medication adherence among vulnerable patients already on an OAM, who filled their medications at Tufts MC Cancer Center pharmacy (to allow for tracking of refill times). 22 We found that in the absence of standardized OAM education only 15% of patients had both adequate understanding of OAM taking and handling, despite self-reports of high adherence. Herein we present the subsequent pilot longitudinal intervention study among patients starting a new OAM.…”

Manejo e descarte dos medicamentos antineoplásicos orais e seus impactos ambientais

“…Quanto aos países de desenvolvimento dos estudos, os Estados Unidos da América se destacaram com nove (47%) pesquisas, seguido do Brasil com quatro (21%), Irlanda com dois (11%) e Arábia Saudita (5%), Croácia (5%), Omã (5%) e Canadá (5%), com um estudo cada. Dos estudos selecionados, seis (32%) eram transversais, sendo um piloto 27 ; outros seis (32%) eram revisões da literatura, dentre as quais uma revisão sistemática 22 ; quatro (21%) eram pesquisas survey, sendo dois desses compostos por mais de um método, mesclando a pesquisa survey com revisões da literatura 6,28 e análise documental 6 ; um (5%) era de método misto; um (5%) era uma pesquisa quantitativa descritiva; e um (5%) se tratava de um grupo focal. Nestes, os pacientes se destacaram como público-alvo em 11 (58%) estudos, os cuidadores em 9 (47%) e os profissionais de saúde em 8 (42%), considerando que alguns artigos citam mais de um público alvo.…”

“…Apesar No que diz respeito ao manejo e ao descarte de antineoplásicos orais, 63% (12) dos estudos focaram em sua importância 11,[20][21][23][24][26][27][28][29][30][31]33 , 42% (8) tiveram como objetivo a identificação das práticas de manejo dos antineoplásicos orais 11,[20][21]26,[29][30][31]33 , 32% (6) buscaram identificar as estratégias educacionais para o manuseio seguro, através da correlação das práticas realizadas com as publicações das diretrizes baseadas em evidências sobre padrões de segurança da terapia antineoplásica oral 18,[22][23]25,28,32 tratamento oncológico 19,27 , e 21% (4) estudos 6,8,23-24 , destacaram os riscos e impactos dos medicamentos oncológicos como contaminantes do meio ambiente.…”