Treatment satisfaction and adherence to oral chemotherapy in patients with cancer

Jamie M. Jacobs, Nicole A. Pensak, Nora J. Sporn, James J. MacDonald, Inga T. Lennes, Steven Safren, William F. Pirl, Jennifer S. Temel, Joseph A. Greer

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose Although patients with cancer overwhelming prefer oral to intravenous chemotherapy, little is known about adherence to oral agents. We aimed to identify the rates and correlates of adherence in patients with diverse malignancies. Materials and Methods Ninety patients with chronic myeloid leukemia or metastatic renal cell carcinoma, non-small-cell lung cancer, or breast cancer enrolled in this prospective, single-group, observational study of medication-taking behaviors. Adherence was measured via selfreport 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. Results As measured by the Medication Event Monitoring System, patients took, on average, 89.3% of their prescribed oral chemotherapy over the12weeks.Onequarter of the sample was less than 90% adherent, and women were more adherent than men (mean difference, 9.59%; SE difference, 4.50%; 95% CI,218.65 to20.52; P = .039). Improvements in patient symptom distress (B = 20.79; 95% CI, 21.41 to 20.18), depressive symptoms (B = -1.57; 95% CI, -2.86 to -0.29), quality of life (B = 0.38; 95% CI ,0.07 to 0.68), satisfaction with clinician communication and treatment (B = 0.73; 95% CI, 0.49 to 0.98), and perceived burden to others (B = 21.28; 95% CI, 22.20 to 20.37) were associated with better adherence. In a multivariate model, improved treatment satisfaction (B = 0.71; 95% CI, 0.48 to 0.94) and reduced perceived burden (B =20.92; 95% CI,21.76 to20.09) were the strongest indicators of better adherence. Conclusion Women and patients who reported increased treatment satisfaction and reduced burden to others were more adherent to oral chemotherapy. Interventions that help patients improve communication with clinicians and reduce burden may optimize oral chemotherapy adherence.

Original languageEnglish (US)
Pages (from-to)e474-e483
JournalJournal of Oncology Practice
Volume13
Issue number5
DOIs
StatePublished - May 1 2017
Externally publishedYes

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Drug Therapy
Neoplasms
Communication
Therapeutics
Quality of Life
Breast Neoplasms
Physiologic Monitoring
Patient Compliance
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Renal Cell Carcinoma
Non-Small Cell Lung Carcinoma
Observational Studies
Depression

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Jacobs, J. M., Pensak, N. A., Sporn, N. J., MacDonald, J. J., Lennes, I. T., Safren, S., ... Greer, J. A. (2017). Treatment satisfaction and adherence to oral chemotherapy in patients with cancer. Journal of Oncology Practice, 13(5), e474-e483. https://doi.org/10.1200/JOP.2016.019729

Treatment satisfaction and adherence to oral chemotherapy in patients with cancer. / Jacobs, Jamie M.; Pensak, Nicole A.; Sporn, Nora J.; MacDonald, James J.; Lennes, Inga T.; Safren, Steven; Pirl, William F.; Temel, Jennifer S.; Greer, Joseph A.

In: Journal of Oncology Practice, Vol. 13, No. 5, 01.05.2017, p. e474-e483.

Research output: Contribution to journalArticle

Jacobs, JM, Pensak, NA, Sporn, NJ, MacDonald, JJ, Lennes, IT, Safren, S, Pirl, WF, Temel, JS & Greer, JA 2017, 'Treatment satisfaction and adherence to oral chemotherapy in patients with cancer', Journal of Oncology Practice, vol. 13, no. 5, pp. e474-e483. https://doi.org/10.1200/JOP.2016.019729
Jacobs, Jamie M. ; Pensak, Nicole A. ; Sporn, Nora J. ; MacDonald, James J. ; Lennes, Inga T. ; Safren, Steven ; Pirl, William F. ; Temel, Jennifer S. ; Greer, Joseph A. / Treatment satisfaction and adherence to oral chemotherapy in patients with cancer. In: Journal of Oncology Practice. 2017 ; Vol. 13, No. 5. pp. e474-e483.
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abstract = "Purpose Although patients with cancer overwhelming prefer oral to intravenous chemotherapy, little is known about adherence to oral agents. We aimed to identify the rates and correlates of adherence in patients with diverse malignancies. Materials and Methods Ninety patients with chronic myeloid leukemia or metastatic renal cell carcinoma, non-small-cell lung cancer, or breast cancer enrolled in this prospective, single-group, observational study of medication-taking behaviors. Adherence was measured via selfreport 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. Results As measured by the Medication Event Monitoring System, patients took, on average, 89.3{\%} of their prescribed oral chemotherapy over the12weeks.Onequarter of the sample was less than 90{\%} adherent, and women were more adherent than men (mean difference, 9.59{\%}; SE difference, 4.50{\%}; 95{\%} CI,218.65 to20.52; P = .039). Improvements in patient symptom distress (B = 20.79; 95{\%} CI, 21.41 to 20.18), depressive symptoms (B = -1.57; 95{\%} CI, -2.86 to -0.29), quality of life (B = 0.38; 95{\%} CI ,0.07 to 0.68), satisfaction with clinician communication and treatment (B = 0.73; 95{\%} CI, 0.49 to 0.98), and perceived burden to others (B = 21.28; 95{\%} CI, 22.20 to 20.37) were associated with better adherence. In a multivariate model, improved treatment satisfaction (B = 0.71; 95{\%} CI, 0.48 to 0.94) and reduced perceived burden (B =20.92; 95{\%} CI,21.76 to20.09) were the strongest indicators of better adherence. Conclusion Women and patients who reported increased treatment satisfaction and reduced burden to others were more adherent to oral chemotherapy. Interventions that help patients improve communication with clinicians and reduce burden may optimize oral chemotherapy adherence.",
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AU - Jacobs, Jamie M.

AU - Pensak, Nicole A.

AU - Sporn, Nora J.

AU - MacDonald, James J.

AU - Lennes, Inga T.

AU - Safren, Steven

AU - Pirl, William F.

AU - Temel, Jennifer S.

AU - Greer, Joseph A.

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N2 - Purpose Although patients with cancer overwhelming prefer oral to intravenous chemotherapy, little is known about adherence to oral agents. We aimed to identify the rates and correlates of adherence in patients with diverse malignancies. Materials and Methods Ninety patients with chronic myeloid leukemia or metastatic renal cell carcinoma, non-small-cell lung cancer, or breast cancer enrolled in this prospective, single-group, observational study of medication-taking behaviors. Adherence was measured via selfreport 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. Results As measured by the Medication Event Monitoring System, patients took, on average, 89.3% of their prescribed oral chemotherapy over the12weeks.Onequarter of the sample was less than 90% adherent, and women were more adherent than men (mean difference, 9.59%; SE difference, 4.50%; 95% CI,218.65 to20.52; P = .039). Improvements in patient symptom distress (B = 20.79; 95% CI, 21.41 to 20.18), depressive symptoms (B = -1.57; 95% CI, -2.86 to -0.29), quality of life (B = 0.38; 95% CI ,0.07 to 0.68), satisfaction with clinician communication and treatment (B = 0.73; 95% CI, 0.49 to 0.98), and perceived burden to others (B = 21.28; 95% CI, 22.20 to 20.37) were associated with better adherence. In a multivariate model, improved treatment satisfaction (B = 0.71; 95% CI, 0.48 to 0.94) and reduced perceived burden (B =20.92; 95% CI,21.76 to20.09) were the strongest indicators of better adherence. Conclusion Women and patients who reported increased treatment satisfaction and reduced burden to others were more adherent to oral chemotherapy. Interventions that help patients improve communication with clinicians and reduce burden may optimize oral chemotherapy adherence.

AB - Purpose Although patients with cancer overwhelming prefer oral to intravenous chemotherapy, little is known about adherence to oral agents. We aimed to identify the rates and correlates of adherence in patients with diverse malignancies. Materials and Methods Ninety patients with chronic myeloid leukemia or metastatic renal cell carcinoma, non-small-cell lung cancer, or breast cancer enrolled in this prospective, single-group, observational study of medication-taking behaviors. Adherence was measured via selfreport 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. Results As measured by the Medication Event Monitoring System, patients took, on average, 89.3% of their prescribed oral chemotherapy over the12weeks.Onequarter of the sample was less than 90% adherent, and women were more adherent than men (mean difference, 9.59%; SE difference, 4.50%; 95% CI,218.65 to20.52; P = .039). Improvements in patient symptom distress (B = 20.79; 95% CI, 21.41 to 20.18), depressive symptoms (B = -1.57; 95% CI, -2.86 to -0.29), quality of life (B = 0.38; 95% CI ,0.07 to 0.68), satisfaction with clinician communication and treatment (B = 0.73; 95% CI, 0.49 to 0.98), and perceived burden to others (B = 21.28; 95% CI, 22.20 to 20.37) were associated with better adherence. In a multivariate model, improved treatment satisfaction (B = 0.71; 95% CI, 0.48 to 0.94) and reduced perceived burden (B =20.92; 95% CI,21.76 to20.09) were the strongest indicators of better adherence. Conclusion Women and patients who reported increased treatment satisfaction and reduced burden to others were more adherent to oral chemotherapy. Interventions that help patients improve communication with clinicians and reduce burden may optimize oral chemotherapy adherence.

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