Impact of Cost-Related Medication Nonadherence on Economic Burdens, Productivity Loss, and Functional Abilities: Management of Cancer Survivors in Medicare

Zhiqiang, Liang; Xiong, Xiaomo; Brown, Jacob; Horras, Ashley; Yuan, Jing; Li, Minghui

doi:10.3389/fphar.2021.706289

Cited by 15 publications

(15 citation statements)

References 31 publications

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“…Older and rural adults are again particularly vulnerable and more likely to experience financial hazards, worsening their economic lifestyle during cancer survivorship [25,57]. For example, such an impact can result in twofold rates of disabilities and activity limitations [29]. Related risk factors include functional impairment, comorbidities, social support, impaired cognitive function and psychological state and financial stress [58].…”

Section: Financial Burden Affects Quality Of Carementioning

confidence: 99%

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

Haier

Schaefers

2022

Cancers

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Within healthcare systems in all countries, vulnerable groups of patients can be identified and are characterized by the reduced utilization of available healthcare. Many different reasons can be attributed to this observation, summarized as implementation barriers involving acceptance, accessibility, affordability, acceptability and quality of care. For many patients, cancer care is specifically associated with the occurrence of vulnerability due to the complex disease, very different target groups and delivery situations (from prevention to palliative care) as well as cost-intensive care. Sociodemographic factors, such as educational level, rural/remote location and income, are known determinants for these vulnerable groups. However, different forms of financial burdens likely influence this vulnerability in cancer care delivery in a distinct manner. In a narrative review, these socioeconomic challenges are summarized regarding their occurrence and consequences to current cancer care. Overall, besides direct costs such as for treatment, many facets of indirect costs including survivorship costs for the cancer patients and their social environment need to be considered regarding the impact on vulnerability, treatment compliance and abundance. In addition, individual cancer-related financial burden might also affect the society due to the loss of productivity and workforce availability. Healthcare providers are requested to address this vulnerability during the treatment of cancer patients.

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Section: Financial Burden Affects Quality Of Carementioning

confidence: 99%

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

Haier

Schaefers

2022

Cancers

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“…In such cases, such patients may opt to forfeit a treatment course without full knowledge of the implications involved. Lu et al (2021), describe these perceptions as misguided since the risks of comorbidities are higher amongst cancer patients who did not adhere to treatment as compared to those who did.…”

Section: Adherence To Treatmentmentioning

confidence: 99%

Health Literacy for Health Behaviour Change—A Study of Cancer Survivors in Nairobi Support Groups

Laura¹,

George²,

Daniel³

2022

JSS

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With the increase of Non-Communicable Diseases (NCDs), Health literacy has emerged as a strategy in improving patient self-care behaviour resulting in reduced morbidity and mortality. As such policy documents have been developed resulting to the integration of patient education in health management systems. This study was conducted with the purpose of assessing specific ways in which health literacy has influenced health behaviour change amongst cancer survivors. Through a survey, a sample of 115 cancer survivors in Nairobi County was interviewed with the use of Semi structured questionnaires and data analyzed using SPSS. Results indicated that most of the respondents were motivated to practice health behaviour due to direct health and medical benefits. In addition, many expressed their confidence in their ability to keep up with health practices inculcated through the health literacy program. However, existing socio-economic challenges delayed the taking up of health practices. This study concluded that health literacy generally produces positive results when articulated in an environment that takes into consideration social and economic factors that could influence individual health habits.

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“…“Increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments” is an important statement in an influential WHO report from 2003 on medication adherence ( Sabaté, 2003 ). The importance of adherence interventions on patients’ health is still most applicable as failure to adhere is a serious problem affecting both patients and healthcare systems by resulting in higher mortality, worsening of disease, more patient injuries, and increased healthcare costs ( Sokol et al, 2005 ; Cutler et al, 2018 ; Khan and Socha-Dietrich, 2018 ; Holbrook et al, 2021 ; Lu et al, 2021 ; Majeed et al, 2021 ; Nymoen et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a new non-disease-specific survey tool to assess self-reported adherence to medication

Larsen

Pripp²,

Krogstad³

et al. 2022

Front. Pharmacol.

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Background: Patients’ non-adherence to medication affects both patients themselves and healthcare systems. Consequences include higher mortality, worsening of disease, patient injuries, and increased healthcare costs. Many existing survey tools for assessing adherence are linked to specific diseases and assessing medication-taking behavior or identifying barriers or beliefs. This study aimed to develop and validate a new non-disease-specific survey tool to assess self-reported medication-taking behavior, barriers, and beliefs in order to quantify the causes of non-adherence and measure adherence.Methods: The survey tool was developed after literature searches and pilot testing. Validation was conducted by assessing the psychometric properties of content, construct, reliability, and feasibility. Content validity was assessed by subject matter experts and construct validity by performing exploratory factor analysis. Reliability assessment was performed by calculating internal consistency, Cronbach’s alpha and test/retest reliability, intraclass correlation coefficient (ICC), and standard error of measurement (SEm). A receiver operating characteristic (ROC) curve and the Lui method were used to calculate the statistical cut-off score for good versus poor adherence. Survey responses from Norwegian medication users over 18 years recruited via social media were used for the factor analysis and Cronbach’s alpha.Results: The final survey tool contains 37 causes of non-adherence connected to medication-taking behavior and barriers to adherence and beliefs associated with adherence. The overall result for all 37 items demonstrated reliable internal consistency, Cronbach’s alpha = 0.91. The factor analysis identified ten latent variables for 29 items, explaining 61.7% of the variance. Seven of the latent variables showed reliable internal consistency: medication fear and lack of effect, conditional practical issues, pregnancy/breastfeeding, information issues, needlessness, lifestyle, and avoiding stigmatization (Cronbach’s alpha = 0.72–0.86). Shortage showed low internal consistency (Cronbach’s alpha = 0.59). Impact issues and personal practical issues showed poor internal consistency (Cronbach’s alpha = 0.51 and 0.48, respectively). The test/retest reliability ICC = 0.89 and SEm = 1.11, indicating good reliability. The statistical cut-off score for good versus poor adherence was 10, but the clinical cut-off score was found to be 2.Conclusion: This survey tool, OMAS-37 (OsloMet Adherence to medication Survey tool, 37 items), demonstrated to be a valid and reliable instrument for assessing adherence. Further studies will examine the ability of the tool for measuring adherence enhancing effect following interventions.

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Impact of Cost-Related Medication Nonadherence on Economic Burdens, Productivity Loss, and Functional Abilities: Management of Cancer Survivors in Medicare

Cited by 15 publications

References 31 publications

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

Economic Perspective of Cancer Care and Its Consequences for Vulnerable Groups

Health Literacy for Health Behaviour Change—A Study of Cancer Survivors in Nairobi Support Groups

Development and validation of a new non-disease-specific survey tool to assess self-reported adherence to medication

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