ASSOCIATIONS BETWEEN THERAPEUTIC REGIMEN-RELATED FACTORS AND MEDICATION ADHERENCE IN PATIENTS ON ORAL ANTICANCER THERAPY

SHAKEEL AHMAD MIR

doi:10.22159/ajpcr.2022.v15i3.44070

Authors

SHAKEEL AHMAD MIR Department of Clinical Pharmacology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i3.44070

Keywords:

Adherence, Cancer, Medication regimen complexity, Anticancer drugs

Abstract

Objective: Good adherence is critical for successful cancer treatment. Complex medication regimens have been found among the various therapy-related factors causing non-adherence.

Methods: In a cross-sectional questionnaire-based study of outpatients, we assessed 75 patients suffering from cancer. The objective of this study is to find associations between therapeutic regimen-related factors and medication adherence in patients on oral anticancer therapy.

Results: There was an increase in medication adherence as the length of therapy increased. About 10.76% of the patients with treatment duration <4 years showed low adherence. Low adherence was not observed with treatment duration of more than 4 years. About 6.55% of those taking up to four drugs had low adherence as compared to 14.28% taking more than 4 drugs. About 8.69% of patients taking drugs up to thrice a day showed low adherence as compared to 16.66% taking more than thrice a day. The negative associations between medication regimen complexity and adherence observed in this study were in the predicted direction but did not achieve statistical significance (p>0.05). The effect size was small (d=0.28)

Conclusion: Complex prescription regimens reduce adherence to oral anticancer treatments, however, there are several other factors to consider than regimen simplification to increase adherence.

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Author Biography

SHAKEEL AHMAD MIR, Department of Clinical Pharmacology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.

Associate Professor

Clinical Pharmacology

References

World Health Organization. Cancer WHO. Geneva: World Health Organization; 2021.

Bedell CH. A changing paradigm for cancer treatment: The advent of new oral chemotherapy agents. Clin J Oncol Nurs 2003;7:5-9.

Catania C, Didier F, Leon ME, Sbanotto A, Mariani L, Nolè F, et al. Perception that oral anticancer treatments are less efficacious: Development of a questionnaire to assess the possible prejudices of patients with cancer. Breast Cancer Res Treat 2005;92:265-72.

Borner M, Scheithauer W, Twelves C, Maroun J, Wilke H. Answering patients’ needs: Oral alternatives to intravenous therapy. Oncologist 2001;6:12-6.

Foulon V, Schöffski P, Wolter P. Patient adherence to oral anticancer drugs: An emerging issue in modern oncology. Acta Clin Belg 2011;66:85-96.

Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc 2011;86:304-14.

Gast A, Mathes T. Medication adherence influencing factors-(updated) overview of systematic reviews. Syst Res 2019;8:1-17.

Jimmy B, Jose J. Patient medication adherence: Measures in daily practice. Oman Med J 2011;26:155-9.

Muir AJ, Sanders LL, Wilkinson WE, Schmader K. Reducing medication regimen complexity: A controlled trial. J Gen Intern Med 2001;16:77-82.

Libby AM, Fish DN, Hosokawa PW, Linnebur SA, Metz KR, Nair KV, et al. Patient-level medication regimen complexity across populations with chronic disease. Clin Ther 2013;35:385-98.e1.

Carter BL, Bergus GR, Dawson JD, Farris KB, Doucette WR, Chrischilles EA, et al. A cluster randomized trial to evaluate physician/ pharmacist collaboration to improve blood pressure control. J Clin Hypertens (Greenwich) 2008;10:260-71.

Wimmer BC, Bell JS, Fastbom J, Wiese MD, Johnell K. Medication regimen complexity and polypharmacy as factors associated with all-cause mortality in older people: A population-based cohort study. Ann Pharmacother 2016;50:89-95.

Partridge AH, Avorn J, Wang PS, Winer EP. Adherence to therapy with oral antineoplastic agents. J Natl Cancer Inst 2002;94:652-61.

Kim SJ, Kwon OD, Han EB, Lee CM, Oh SW, Joh HK, et al. Impact of number of medications and age on adherence to antihypertensive medications: A nationwide population-based study. Medicine 2019;98:e17825.

Naqvi AA, Hassali MA, Rizvi M, Zehra A, Iffat W, Haseeb A, et al. Development and validation of a novel general medication adherence scale (GMAS) for chronic illness patients in Pakistan. Front Pharmacol 2018;9:1124.

Verbrugghe M, Duprez V, Beeckman D, Grypdonck M, Quaghebeur M, Verschueren C, et al. Factors influencing adherence in cancer patients taking oral tyrosine kinase inhibitors: A qualitative study. Cancer Nurs 2016;39:153-62.

Claxton AJ, Cramer J, Pierce C. A systematic review of the associations between dose regimens and medication compliance. Clin Ther 2001;23:1296-310.

Brito C, Portela MC, de Vasconcellos MT. Adherence to hormone therapy among women with breast cancer. BMC Cancer 2014;14:397.

Noens L, van Lierde MA, De Bock R, Verhoef G, Zachée P, Berneman Z, et al. Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: The ADAGIO study. Blood 2009;113:5401-11.

Partridge AH, Wang PS, Winer EP, Avorn J. Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 2003;21:602-6.

Jin J, Sklar GE, Oh MS, Li SC. Factors affecting therapeutic compliance: A review from the patient’s perspective. Ther Clin Risk Manag 2008;4:269-86.