Oral Chemotherapy Adherence Affected by Patient Satisfaction With Oncologist and Treatment

A new study has explored factors that impact patient adherence to oral chemotherapy regimens and found that improved satisfaction with their treatment and clinician was most strongly linked to better adherence.

Oral chemotherapy agents reduce some of the burden of treatment for patients compared with traditional intravenous chemotherapy, but not much is known about the rates of adherence to this newer type of drug, according to the study published in the Journal of Oncology Practice. Researchers measured adherence among a small cohort of patients receiving oral anticancer therapy over a 12-week study period.

Along with capturing adherence rates through a pill bottle that electronically records each time the cap is opened, the study authors administered assessments at baseline and follow-up to capture self-reported measures. These variables included perceived adherence, symptom distress, anxiety and depression symptoms, quality of life, cancer-specific psychological distress, and satisfaction with clinician communication and treatment. The patients also reported their sociodemographic characteristics and the researchers collected clinical data from their electronic health records.

Less than one-fourth (24.4%) of participants had perfect adherence, and slightly more (25.6%) were determined to be poorly adherent based on a cutoff of 90% adherence. The only baseline or patient characteristic that had a significant effect on adherence was sex, as women had significantly greater adherence levels than men. Interestingly, there were no associations found between adherence and educational attainment, income, marital status, or employment, although prior studies have indicated that socioeconomic status and social support can impact adherence.

When comparing the changes in patient-reported measures from baseline to follow-up, the researchers found that patients tended to have higher levels of adherence when they reported their symptom distress, depressive symptoms, and perceived burden to family and friends declined over the study period. Likewise, improvements during this time in self-reported quality of life and satisfaction with clinician communication and treatment were associated with higher levels of adherence.

Together, the multivariable model composed of the strongest predictors accounted for 41% of the variance in adherence. The changes in treatment satisfaction and, to a lesser degree, perceived burden were the most significant, as when they were removed from the model, the other 3 predictors no longer were significant drivers of adherence.

“Increased treatment satisfaction was the most robust predictor of adherence, suggesting the need to enhance patient-clinician relationships and implement patient-centered care models in oncology to ensure optimal outcomes,” the study authors wrote.