Oral chemotherapy has become a widely utilized cancer treatment modality. While there are many benefits, such as ease of administration, self- or home administration of these agents presents challenges. Adherence is a major challenge, and study findings as well as observations in clinical practice suggest that adherence is difficult to assess and measure, and adherence rates may not be 100% for many patients.
Researchers from several US cancer centers collaborated on a study of oral chemotherapy medication-taking behaviors. Ninety patients with chronic myeloid leukemia or metastatic renal cell carcinoma, non–small-cell lung cancer, or breast cancer were enrolled in the study. Adherence was measured via self-report and with an electronic pill cap (Medication Event Monitoring System cap). Patients completed surveys regarding symptom distress, mood, quality of life, cancer-specific distress, and satisfaction with clinician communication and treatment at baseline and 12-week follow-up.
Patients took, on average, 89.3% of their prescribed oral chemotherapy over the 12 weeks; however, 25% were less than 90% adherent, and women were more adherent than men. Improvements in patient symptom distress, depressive symptoms, quality of life, satisfaction with clinician communication and treatment, and perceived burden to others were associated with better adherence.
This may be one of the first adherence studies to specifically assess patient-clinician communication satisfaction, and interventions that improve communication may optimize oral chemotherapy adherence. The study findings are available here.