Patient perspectives on the barriers associated with medication adherence to oral chemotherapy

Abstract

Purpose Appropriate use of oral chemotherapy is a challenge for patients and clinicians. The purpose of this study was to analyze cancer patients' use of oral chemotherapies and identify opportunities to improve adherence. Methods We developed a 30-question survey to address frequency and reasons for reducing/skipping doses; sources of information for oral chemotherapy use; perceived importance of food-drug effects; and ease of understanding labeling directions. Results Ninety-three patients taking oral chemotherapies with chronic myeloid leukemia, renal cell carcinoma, breast cancer, and colorectal cancer completed the survey. This was a well-educated population with 69% (n = 62) having completed some college; 51% (n = 47) female and 59% (n = 54) older than 50 years of age. Thirty percent of patients reported forgetting to take their oral chemotherapy at least "sometimes". Younger patients (<50 vs. ≥50, p = 0.002), shorter treatment duration (<6 vs. ≥6 months p = 0.03), or with chronic myeloid leukemia (vs. other diagnoses, p = 0.015) forget to take their oral chemotherapy at higher rates. Twenty-three percent (n = 21) indicated they intentionally skipped their oral chemotherapies and 38% (n = 8) of those did not inform their physicians. Forty-one percent (n = 28) taking drugs with significant food-drug effects did not think about their last meal before taking their oral chemotherapy and 80% (n = 55) did not understand the potential interactions. Additionally, 39% (n = 36/92) never looked at labeling and 15% (n = 14/91) had difficulty understanding label directions. Conclusion There are three main barriers associated with appropriate use of oral chemotherapies: misunderstanding about the timing of drug with food; stopping drug without informing physicians; and difficulty understanding labeling directions. A multipronged approach is needed to optimize communication of directions for optimal oral chemotherapy use.

Determinants of khat chewing among urban households of Wolkite Town, Gurage Zone, Ethiopia

“…The result implies education enhances individual knowledge in social, economical and health related cases and those educated individuals may be keeping them from chewing khat. This is in line with the finding of Muluneh et al (2018) who revealed that integrate education of the potential health problems of khat chewing is important to reduce the number of chewers.…”

“…Furthermore, chewing of khat has serious socioeconomic effect on households' income to fulfill nutritious food, home improvement, education or other family needs and finally leads to financial problem and family breakdown. It also affects working hours, causes absenteeism from work, absenteeism from class and poor academic performance of the students and unemployment (Amsalu et al, 2017;Beyene et al, 2017;Ng'ethe, 2015;Muluneh, 2018).…”

“…Among them are normalization in the community, social mobility to most khat chewing community, perceived non -side effect, affordability, type of occupation and availability of khat leaf in the whole year (Haile et al, 2015;Megerssa et al, 2014). Likewise, joblessness, less family level control of khat chewing, absence of social banned mechanism, khat chewing as indicator of city boy at higher educational institutions, lack of interest to work and family dependence are factors that increase the number of chewers (Muluneh, 2018). Besides, limited attention on the socio-economic and health consequences and absence of government interference to control consumption cause the expansion of khat in Ethiopia.…”

Oral Medication Adherence Among Adolescents and Young Adults with Cancer Before and Following Use of a Smartphone-Based Medication Reminder App

“…Similar to previous studies, forgetfulness was the most frequently cited reason for nonadherence. 3,7,13,40 Responses also provided insights into AYA lifestyle factors that could guide future intervention, including reports of being away from home when medication doses were missed. Interventions could help AYAs develop proactive plans for medication-taking for times that they are away from home or out of their usual routine.…”

Orally Administered Cancer Therapy: Breaking Down Barriers to Adherence and Quality of Life

“…Other team members, such as clinical oncology pharmacists and seasoned clinical nursing staff, should be integrated into the care team to support communication of personalized treatment plans, dosing schedules, FDA labeling instructions, expected side effect profiles, and management of side effects. 2 Similarly, other team members, such as social workers, can help in other QoL domains. Regular evaluation of a patient's social support is vital to identify deficiencies that may require additional measures, such as more frequent check-ins or assistance with transportation.…”