Medication Adherence in Cancer Patients: A Comprehensive Review

V, Reshma; Chacko, Arun M; Abdulla, Naseeha; Annamalai, Maduram; Kandi, Venkataramana

doi:10.7759/cureus.52721

Cureus

2024

DOI: 10.7759/cureus.52721

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Medication Adherence in Cancer Patients: A Comprehensive Review

Reshma V,

Arun M Chacko,

Naseeha Abdulla

et al.

Abstract: Cancer is a complex disease that can affect different parts of the body. The rates of cancer have shown an increasing trend in the past decade. A majority of cancers are detected late, therefore becoming untreatable and resulting in significant mortality. Additionally, the lack of awareness about cancers, their risk factors, diagnostic modalities, and preventive measures contributes to increased burden among people. Despite significant developments in the therapeutic and comprehensive management of cancers, th… Show more

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Cited by 3 publications

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Trauma Informed Care and early distress identification in oncology settings

Simkhaev

2024

Journal of Psychosocial Oncology

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Trauma Informed Care and early distress identification in oncology settings

Simkhaev

2024

Journal of Psychosocial Oncology

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Barriers to cancer treatment for people experiencing socioeconomic disadvantage in high-income countries: a scoping review

Bourgeois,

Horrill,

Mollison

et al. 2024

BMC Health Serv Res

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Background Despite advances in cancer research and treatment, the burden of cancer is not evenly distributed. People experiencing socioeconomic disadvantage have higher rates of cancer, later stage at diagnoses, and are dying of cancers that are preventable and screen-detectable. However, less is known about barriers to accessing cancer treatment. Methods We conducted a scoping review of studies examining barriers to accessing cancer treatment for populations experiencing socioeconomic disadvantage in high-income countries, searched across four biomedical databases. Studies published in English between 2008 and 2021 in high-income countries, as defined by the World Bank, and reporting on barriers to cancer treatment were included. Results A total of 20 studies were identified. Most (n = 16) reported data from the United States, and the remaining included publications were from Canada (n = 1), Ireland (n = 1), United Kingdom (n = 1), and a scoping review (n = 1). The majority of studies (n = 9) focused on barriers to breast cancer treatment. The most common barriers included: inadequate insurance and financial constraints (n = 16); unstable housing (n = 5); geographical distribution of services and transportation challenges (n = 4); limited resources for social care needs (n = 7); communication challenges (n = 9); system disintegration (n = 5); implicit bias (n = 4); advanced diagnosis and comorbidities (n = 8); psychosocial dimensions and contexts (n = 6); and limited social support networks (n = 3). The compounding effect of multiple barriers exacerbated poor access to cancer treatment, with relevance across many social locations. Conclusion This review highlights barriers to cancer treatment across multiple levels, and underscores the importance of identifying patients at risk for socioeconomic disadvantage to improve access to treatment and cancer outcomes. Findings provide an understanding of barriers that can inform future, equity-oriented policy, practice, and service innovation.

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Imatinib Adherence and Persistence in Patients with Chronic Myeloid Leukemia in Belgium: Evidence from Real-World Data

Michiels,

Tricas-Sauras,

Salaroli

et al. 2024

PPA

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Purpose Imatinib adherence and persistence are key components of the successful treatment of Chronic Myeloid Leukemia (CML). In Belgium, there is no study assessing these behaviors at a national level. Our study aimed to provide the first nationwide measure and to identify associated pharmacy-based predictors (age, gender, comorbidities). We also assessed mortality and transplantation incidence according to adherence status. Methods Based on medico-administrative database linkage, we identified a retrospective Belgian cohort of 1194 patients diagnosed with CML between 2004 and 2016 and treated with imatinib. Adherence was measured over 24 months, considering the proportion of days covered (PDC). Persistence was measured as the time until discontinuation (gap of ≥90 days). Multivariable Poisson regression models with robust standard error were conducted to identify predictors associated with adherence (≥90% PDC). To identify factors associated with persistence, a multivariable Cox regression was performed. Results At six months, 60.3% of patients were adherent, declining to 41.5% at 12 months, and to 30.1% at two-year follow-up (n=998). Adherence was greater at a younger age (eg 31–40 years vs ≥75 years, adjusted prevalence ratio (aPR) 1.73; 95% confidence interval (CI): 1.09–2.77) and among patients with no comorbidity (0 vs ≥2 comorbidities (aPR 1.56; 95% CI: 1.11–2.19). The median persistence was 334.5 days (Q1:200–Q3:505.5); persistence at 24 months was 83.6% (n=998). Only age was associated with higher risk of discontinuation, with adjusted hazard ratio (aHR) of 6.05 for patients ≥75 years (95% CI: 5.52–6.58). Transplants and deaths mainly occurred in patients defined as non-adherent at 24 months. Conclusion This Belgian nationwide representative study revealed a critical low level of imatinib adherence, which decreased over time even though persistence was high at six months. We pinpointed pharmacy-based predictors that were easily identifiable by health care stakeholders in order to undertake interventions to improve adherence.

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Medication Adherence in Cancer Patients: A Comprehensive Review

Cited by 3 publications

References 51 publications

Trauma Informed Care and early distress identification in oncology settings

Trauma Informed Care and early distress identification in oncology settings

Barriers to cancer treatment for people experiencing socioeconomic disadvantage in high-income countries: a scoping review

Imatinib Adherence and Persistence in Patients with Chronic Myeloid Leukemia in Belgium: Evidence from Real-World Data

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