Patient Experiences With Oral Chemotherapy: Adherence, Symptoms, and Quality of Life
Autor: | William F. Pirl, Molly Ream, Joseph A. Greer, Jennifer S. Temel, James J. MacDonald, Lauren Nisotel, Nicole Pensak, Joel N. Fishbein, Steven A. Safren, Jamie M. Jacobs, Inga T. Lennes, Joanne S. Buzaglo |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty MEDLINE Administration Oral Medication Adherence law.invention Young Adult 03 medical and health sciences Social support 0302 clinical medicine Randomized controlled trial Quality of life law Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols Electronic Health Records Humans Medicine 030212 general & internal medicine Young adult Aged Randomized Controlled Trials as Topic Aged 80 and over business.industry Middle Aged Mood Socioeconomic Factors Oncology Health Care Surveys 030220 oncology & carcinogenesis Pill Quality of Life Anxiety Female medicine.symptom business |
Zdroj: | Journal of the National Comprehensive Cancer Network. 17:221-228 |
ISSN: | 1540-1413 1540-1405 |
Popis: | 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 (r= −0.20). 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]=50.53; adjustedR2=0.77). Anxiety symptoms were most strongly associated with clinically meaningful decrements in QoL (β= −7.10; SE=0.22).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. |
Databáze: | OpenAIRE |
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