Barriers and Facilitators of Adherence to Oral Anticancer Medications Among Women with Breast Cancer: A Qualitative Study

Abstract

Despite the life-saving benefits of oral anticancer medications (OAMs) to women with breast cancer (BC), adherence remains suboptimal and, in many cases, not well documented. The study examined barriers and facilitators of adherence to OAMs among women receiving BC treatment in Nigeria. Patients and Methods:The study was framed within the World Health Organization (WHO) Multidimensional Model of Adherence. We conducted qualitative in-depth interviews of 16 purposively sampled women in two tertiary hospitals in Southern Nigeria. The interviews were audio-recorded and transcribed verbatim. The interview data were analyzed using the Framework Method. Results:The key barriers to OAM adherence mentioned were socioeconomic factors (high cost of medication) and therapy-related factors (medication side effects). The key facilitating mechanisms for adherence to OAMs mentioned included; (i) patient-related psychosocial factors such as self-encouragement and self-discipline in sticking to the prescription, taking the medication at a particular time each day, receiving practical support from family members; and (ii) healthcare team/system factors such as obtaining an adequate supply of the medication at the pharmacy. Conclusion: Barriers and facilitators to OAM adherence are multidimensional. The study findings highlight the potential benefit of a multifaceted intervention (such as patient education and monitoring or strategies promoting cost-containment and side effects management) to optimize adherence. Therefore, our findings may inform the designing and evaluating of context-specific adherence measures and multifaceted intervention strategies targeting key barriers and approaches that enable adherence to enhance patient outcomes.

Digging in real-word electronic database for assessing CDK 4/6 inhibitors adherence in breast cancer patients from Romania

“…The routine of frequent medication intake was proved to be one of the important barriers of adherence to oral anticancer medications among patients with breast cancer (Onwusah et al, 2023). It is important to emphasize that, despite the distinct administration schedules of CDK 4/6 inhibitors (ribociclib and palbociclib are administered once daily for 21 consecutive days followed by 7 days without treatment, while abemaciclib is administered continuously), medication adherence did not differ among the three patient groups.…”