TY - JOUR
T1 - Patient experiences with oral chemotherapy
T2 - Adherence, symptoms, and quality of life
AU - Jacobs, Jamie M.
AU - Ream, Molly E.
AU - Pensak, Nicole
AU - Nisotel, Lauren E.
AU - Fishbein, Joel N.
AU - MacDonald, James J.
AU - Buzaglo, Joanne
AU - Lennes, Inga T.
AU - Safren, Steven A.
AU - Pirl, William F.
AU - Temel, Jennifer S.
AU - Greer, Joseph A.
N1 - Funding Information:
Funding: Research reported in this manuscript was funded through a Patient-Centered Outcomes Research Institute Award (IHS-1306-03616).
Funding Information:
Disclosures: Dr. Lennes has disclosed that she has received honorarium from BCBS Massachusetts and has received compensation by Kyruus for consulting/advisory work. Dr. Safren has disclosed that he has received book royalties from Oxford University Press, Guilford Press, and Springer/Human Press. Dr. Temel has disclosed that she has received research funding from Pfizer. The remaining authors have disclosed that they have not received any financial considerations from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding Information:
Research reported in this manuscript was funded through a Patient-Centered Outcomes Research Institute Award (IHS-1306-03616).
Publisher Copyright:
© 2019 Harborside Press. All rights reserved.
PY - 2019/3
Y1 - 2019/3
N2 - Background: Oral therapies are increasingly common in oncology care. However, data are lacking regarding the physical and psychologic symptoms patients experience, or how these factors relate to medication adherence and quality of life (QoL). Materials and Methods: From December 2014 through August 2016, a total of 181 adult patients who were prescribed oral targeted therapy or chemotherapy enrolled in a randomized study of adherence and symptom management at Massachusetts General Hospital Cancer Center. Patients completed baseline assessments of adherence with electronic pill cap, QoL, symptom severity, mood, social support, fatigue, and satisfaction with clinicians and treatment. Relationships among these factors were examined using Pearson product-moment correlations and multivariable linear regression. Results: At baseline, the mean electronic pill cap adherence rate showed that patients took 85.57% of their oral therapy. The most commonly reported cancer-related symptoms were fatigue (88.60%), drowsiness (76.50%), disturbed sleep (68.20%), memory problems (63.10%), and emotional distress (60.80%). Patients who reported greater cancer-related symptom severity had lower adherence (r5 20.20). In a multivariable regression, greater depressive and anxiety symptoms, worse fatigue, less social support, lower satisfaction with clinicians and treatment, and higher symptom burden were associated with worse QoL (F [10, 146]550.53; adjusted R 2 50.77). Anxiety symptoms were most strongly associated with clinically meaningful decrements in QoL (b5 27.10; SE50.22). Conclusions: Patients prescribed oral therapies struggle with adherence, and cancer-related symptom burden is high and related to worse adherence and QoL. Given perceptions that oral therapies are less impairing, these data underscore the strong need to address adherence issues, symptom burden, and QoL for these patients.
AB - Background: Oral therapies are increasingly common in oncology care. However, data are lacking regarding the physical and psychologic symptoms patients experience, or how these factors relate to medication adherence and quality of life (QoL). Materials and Methods: From December 2014 through August 2016, a total of 181 adult patients who were prescribed oral targeted therapy or chemotherapy enrolled in a randomized study of adherence and symptom management at Massachusetts General Hospital Cancer Center. Patients completed baseline assessments of adherence with electronic pill cap, QoL, symptom severity, mood, social support, fatigue, and satisfaction with clinicians and treatment. Relationships among these factors were examined using Pearson product-moment correlations and multivariable linear regression. Results: At baseline, the mean electronic pill cap adherence rate showed that patients took 85.57% of their oral therapy. The most commonly reported cancer-related symptoms were fatigue (88.60%), drowsiness (76.50%), disturbed sleep (68.20%), memory problems (63.10%), and emotional distress (60.80%). Patients who reported greater cancer-related symptom severity had lower adherence (r5 20.20). In a multivariable regression, greater depressive and anxiety symptoms, worse fatigue, less social support, lower satisfaction with clinicians and treatment, and higher symptom burden were associated with worse QoL (F [10, 146]550.53; adjusted R 2 50.77). Anxiety symptoms were most strongly associated with clinically meaningful decrements in QoL (b5 27.10; SE50.22). Conclusions: Patients prescribed oral therapies struggle with adherence, and cancer-related symptom burden is high and related to worse adherence and QoL. Given perceptions that oral therapies are less impairing, these data underscore the strong need to address adherence issues, symptom burden, and QoL for these patients.
UR - http://www.scopus.com/inward/record.url?scp=85062869953&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85062869953&partnerID=8YFLogxK
U2 - 10.6004/jnccn.2018.7098
DO - 10.6004/jnccn.2018.7098
M3 - Article
C2 - 30865917
AN - SCOPUS:85062869953
VL - 17
SP - 221
EP - 228
JO - JNCCN Journal of the National Comprehensive Cancer Network
JF - JNCCN Journal of the National Comprehensive Cancer Network
SN - 1540-1405
IS - 3
ER -