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Nonadherence in Adolescent Oncology Patients: Preliminary Data on Psychological Risk Factors and Relationships to Outcome
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“As a consequence, patients with psychosocial distress show greater nonadherence to treatment recommendations [3]”
From Development of a screening tool for the identification of psychooncological treatment need in breast cancer patients (2009) · cites this paper as [3]
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“INTRODUCTION Depression is one of the strongest determinants of health-related quality of life and it can influence medical care and participation in treatment.(1) 2 It may also be linked with other serious outcomes including mortality.”
BackgroundEffects of a Cancer Survivorship Clinic—preliminary results
Jammu, A. S., Chasen, M. R., van Heest, R., Hollingshead, S., Kaushik, D., Gill, H., & Bhargava, R. (2019) · Supportive Care in Cancer · doi:10.1007/s00520-019-05067-7 · Cited by 14
Vandermorris, A., Sampson, L., & Korenblum, C. (2019) · Pediatric Blood & Cancer · doi:10.1002/pbc.28128 · Cited by 16
Associated factors of distress in patients with advanced cancer: A retrospective study
Huertas, L. A., Allende‐Pérez, S., & Pastrana, T. (2020) · Palliative & Supportive Care · doi:10.1017/s1478951520001066 · Cited by 15
“The presence of higher distress in younger patients (DT score ≥4) coincided with findings reported in the literature (Van Scheppingen et al., 2011; Goulia et al., 2012; Kim et al., 2013; Haynes-Lewis et al., 2018).”
ResultLoquai, C., Scheurich, V., Syring, N., Schmidtmann, I. M., Müller-Brenne, T., Werner, A., Grabbe, S., & Beutel, M. E. (2014) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.12361 · Cited by 13
Admiraal, J. M., Hoekstra‐Weebers, J. E. H. M., Schröder, C. P., Tuinier, W., Hospers, G. A. P., & Reyners, A. K. L. (2019) · Supportive Care in Cancer · doi:10.1007/s00520-019-05030-6 · Cited by 13
Dealing with Cancer-Related Distress
Abrahamson, K. A. (2010) · AJN American Journal of Nursing · doi:10.1097/01.naj.0000370162.07674.f6 · Cited by 13
Günther, M. P., Schulze, J. B., Jellestad, L., Mehnert, A., von Känel, R., & Euler, S. (2021) · Psycho-Oncology · doi:10.1002/pon.5743 · Cited by 13
Günther, M. P., Kirchebner, J., Schulze, J. B., Känel, R., & Euler, S. (2022) · European Journal of Cancer Care · doi:10.1111/ecc.13555 · Cited by 11
Distress screening in endometrial cancer leads to disparity in referral to support services
Reid, H., Broadwater, G., de Oca, M. K. M., Selvan, B., Fayanju, O. M., Havrilesky, L. J., & Davidson, B. A. (2022) · Gynecologic Oncology · doi:10.1016/j.ygyno.2022.01.001 · Cited by 11
Screening for Distress in Young People After Treatment for Sarcoma
Weiner, B., Michelagnoli, M. P., Drake, R., & Christie, D. (2015) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454214563933 · Cited by 11
“Jacobsen et al. (2005) suggest that distress often goes unnoticed in cancer patients and this contributes to nonadherence to treatment recommendations (Von Essen, Larsson, Oberg, & Sjoden, 2002) and causes patients to report poor satisfaction with care (Kennard et al., 2004).”
BackgroundPeled, O., Lavan, O., Stein, J., Vinograd, I., Yahel, A., Valevski, A., Weizman, A., Kimmel-Tamir, E., Apter, A. S., Fennig, S., et al. (2020) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2019.0164 · Cited by 11
“…on the quality of life of young cancer patients, affecting participation in and compliance with the complicated treatment regimens that are most often employed in the pediatric oncology ward (Shemesh et al. 2002; Kennard et al. 2004; DeJong and Fombonne 2007; Bender et al. 2014; Shim et al. 2018).”
McGrady, M. E., Prosser, L. A., Thompson, A. N., & Pai, A. L. H. (2017) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsx104 · Cited by 10
“…antibiotic; antifungal) medications included in cancer treatment protocols is demonstrated by 27–60% of adolescents and young adults (ages 15–24 years) with cancer (Butow et al., 2010) and is associated with treatment failure (i.e., relapse; Bhatia et al., 2015) and death (Kennard et al., 2004).”
BackgroundLoth, F. L. C., Meraner, V., Holzner, B., Singer, S., Virgolini, I. J., & Gamper, E. (2018) · Psycho-Oncology · doi:10.1002/pon.4675 · Cited by 10
Severe mental illness in cancer is associated with disparities in psycho-oncological support
Günther, M. P., Schulze, J. B., Kirchebner, J., Jordan, K.-D., von Känel, R., & Euler, S. (2022) · Current Problems in Cancer · doi:10.1016/j.currproblcancer.2022.100849 · Cited by 10
Barriers to medication adherence and its relationship with outcomes in pediatric dialysis patients
Silverstein, D. M., Fletcher, A., & Moylan, K. (2014) · Pediatric Nephrology · doi:10.1007/s00467-014-2780-0 · Cited by 10
“Patient level factors include type and severity of disease, age (being lowest in adolescence) [1], family dynamics [2, 3] psychosocial conditions [4, 5] and health literacy and beliefs [6–8].”
BackgroundAdherence to medication: A nation-wide study from the Children’s Cancer Hospital, Egypt
Malla, H. E. (2013) · World Journal of Psychiatry · doi:10.5498/wjp.v3.i2.25 · Cited by 11
Jacobs, M., Anderegg, M. C. J., Schoorlemmer, A., Nieboer, D., Steyerberg, E. W., Smets, E. M. A., Sprangers, M. A. G., Henegouwen, M. I. V. B., de Haes, J. C. J. M., & Klinkenbijl, J. H. G. (2016) · Psycho-Oncology · doi:10.1002/pon.4161 · Cited by 10
“Chronic and untreated, distress or any of its associated problems such as depression, can result in poorer adherence to treatment [9,10], satisfaction with care [9,11], quality of life [9,12,13], and even survival [14,15].”
BackgroundCain-Trivette, C. J., Meisman, A. R., Drucker, K., Isaac, E. I., Verma, T., Griffin, J., & Rohan, J. M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17061956 · Cited by 9
Isaac, E. I., Meisman, A. R., Drucker, K., Violante, S., Behrhorst, K. L., Floyd, A. L., & Rohan, J. M. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17072218 · Cited by 10
“, anxiety, depression, financial stressors, limited social supports), which has been shown to negatively impact health behaviors and health outcomes over time [13,14,17,20,28,38,41,42].”
BackgroundInfluentialPsihogios, A. M., Rabbi, M., Ahmed, A., McKelvey, E. R., Li, Y., Laurenceau, J., Hunger, S. P., Fleisher, L. G., Pai, A. L. H., Schwartz, L. A., et al. (2021) · JMIR Research Protocols · doi:10.2196/32789 · Cited by 9
“…studies have begun to identify contextual risk factors for oral chemotherapy nonadherence, including physical symptoms [10,11], negative mood [10,12], low motivation [13,14], difficult family interactions [15-17], and environmental factors (eg, being outside of the home) [15,17,18], these…”
Psychological distress and prostate specific antigen levels in men with and without prostate cancer
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Psychosocial risk, symptom burden, and concerns in families affected by childhood cancer
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Carr, E., & Rosengarten, L. (2021) · Journal of Pediatric Oncology Nursing · doi:10.1177/1043454221992302 · Cited by 7
“Cancer is the leading cause of nonaccidental death in adolescents, with research significantly suggesting that between 50% and 63% of patients do not adhere to their treatment (Kennard et al., 2004; Kondryn et al., 2011; Teenage Cancer Trust, 2014).”
InfluentialAl-Hussaini, M. A., Abdel‐Razeq, H., Shamieh, O. M., Al-Ani, A. T., Hammouri, M., & Mansour, A. H. (2024) · The Oncologist · doi:10.1093/oncolo/oyae193 · Cited by 10
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“Notably, AYAs experience a high burden of mental health conditions, which have been linked to nonadherence [29, 69].”
BackgroundMethodLeimanis, M. L. (2014) · International Journal of Physical Medicine & Rehabilitation · doi:10.4172/2329-9096.1000193 · Cited by 6
Psychosocial Adjustment and Adherence of Children and Adolescents on Dialysis
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“Mental health challenges associated with cancer treatment have been linked to lower treatment adherence (Hershman et al., 2016; Kennard et al., 2004) and increased risk of mortality (Wang et al., 2020).”
Quality of life in patients with non-small cell lung cancer
Šarac, S., Milić, R., Vasiljevic, M., & Šarac, M. (2016) · Vojnosanitetski pregled · doi:10.2298/vsp160125117s · Cited by 5
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One-minute time interval estimation as a novel ultrashort tool for distress screening
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“Research indicates that high levels of distress negatively affect the quality of life (QoL) [6,7], patient satisfaction with treatment [8,9] and treatment adherence [10,11].”
BackgroundReid, H., Selvan, B., de Oca, M. K. M., Falkovic, M., Malone, S., Fish, L. J., Wheeler, S. M., & Davidson, B. A. (2022) · Gynecologic Oncology · doi:10.1016/j.ygyno.2022.11.008 · Cited by 4
Consequences of Nonadherence and Correlates of Adherence
Rapoff, M. A., Duncan, C. L., & Karlson, C. (2023) · Issues in clinical child psychology · doi:10.1007/978-3-031-27484-8_2 · Cited by 4
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Psychological Care of Adult Allogeneic Transplant Patients
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“This can have grave consequences; like poorer quality of life [13], [14], lesser satisfaction with care [15], and even greater noncompliance to treatment [16], [17].”
BackgroundSalvador, Á., Mansuklal, S. A., Moura, M. A. J. D. S., Crespo, C., & Barros, L. (2023) · Journal of Child Health Care · doi:10.1177/13674935231208502 · Cited by 3
“…were reported as facilitators (Psihogios et al., 2020, 2021), worse family functioning, family dif fi culties in managing condition/treatment (Psihogios et al., 2020), and parent – child incongruence in describing family environment (Kennard et al., 2004) may negatively impact adherence.”
InfluentialMedication adherence in leukemia children receiving home-based treatment and its related factors
Zhong, D., Xiang, Q., Liu, Y., Ma, L., Zhang, L., Shen, X., & Mo, L. (2023) · Hematology · doi:10.1080/16078454.2023.2227490 · Cited by 3
“Patients who did not adhere to oral antibiotic preventative drugs had signi fi cantly lower survival rates than those who did [11].”
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Precisión diagnóstica del termómetro de distrés en neoplasias hematológicas
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“[9] 11 – 14] Emotional distress is less likely in those aged older than 65 years.”
BackgroundLavan, O., Peled, O., Avishai-Neumann, M., Weizman, A., Yahel, A., Apter, A. S., Valevski, A., Fennig, S., Stein, J., & Benaroya-Milshtein, N. (2022) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2021.0083 · Cited by 2
“Furthermore, depression and anxiety are associated with treat-ment nonadherence (Kennard et al. 2004; Portteus et al. 2006; Kurtz and Abrams 2010; Arrieta et al. 2013; Caruso et al. 2017; Shim et al. 2018), which can have devastating ramifications on treatment efficacy and the risk of disease relapse…”
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“Moreover, the underestimation and insufficient treatment of emotional disorders and distress may lead to some negative results; for example, the lower rate of satisfaction with medical service (10, 11), decreased patient’s quality of life and their relatives (12, 13), long hospitalization (14), low therapy compliance…”
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“Poor adherence has been cited as the single greatest cause of treatment failure (Quittner, Modi, Lemanek, Ievers-Landis, & Rapoff, 2008), and has been linked to increased morbidity and mortality (Kennard et al., 2004; Falkenstein, Flynn, Kirkpatrick, Casa-Melley, & Dunn, 2004).”
InfluentialAdherencia a medicación antineoplásica oral en oncología pediátrica. Estudio multicéntrico
(2021) · Archivos Argentinos de Pediatria · doi:10.5546/aap.2021.44
Sinha, S., Pandey, S., Salins, S. L., Salins, N. S., Deodhar, J. K., Gupta, T., Laskar, S. G., Budrukkar, A. N., Swain, M., Kumar, A., et al. (2023) · South Asian Journal of Cancer · doi:10.1055/s-0043-1771405 · Cited by 2
Konsequenzen der Nicht-Adhärenz und Korrelate der Adhärenz
Rapoff, M. A., Duncan, C. L., & Karlson, C. (2025) · Springer eBooks · doi:10.1007/978-3-031-86845-0_2
McGrady, M. E., Ketterl, T. G., Tillery, R., Burns, M. M. K., Bills, S. E., Burke, M., Szulczewski, L., Brock, M. Y., Schwartz, L. E., Herriott, J. K., et al. (2025) · Pediatric Blood & Cancer · doi:10.1002/pbc.32127
Treatment Adherence and Self-Management in Adolescent and Young Adult Oncology
McGrady, M. E., Tillery, R., & Wolfson, J. A. (2025) · Journal of Adolescent and Young Adult Oncology · doi:10.1177/21565333251393029
Stoppa, M., Bagliacca, E. P., Russo, S., Rampoldi, G., Strepparava, M. G., Balduzzi, A., Biondi, A., & Spinelli, M. (2026) · Pediatric Blood & Cancer · doi:10.1002/1545-5017.70491
“…compared to some other oncological populations due to the prolonged duration of active treatment, the burden of maintenance therapies requiring sustained adherence, the persistent uncertainty related to relapse risk and the possible need for haematopoietic stem cell transplantation [ 2, 6, 8 ].”
Metadata
- Authors
- Kennard, B. D., Stewart, S. M., Olvera, R., Bawdon, R. E., hAilin, A. O., Lewis, C. P., & Winick, N. J.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Children's Medical Center (US)
- The University of Texas at Dallas (US)
- Corresponding author
- Kennard, Beth D.
- Venue
- Journal of Clinical Psychology in Medical Settings
- Published
- 2004-03
- Volume
- 11
- Issue
- 1
- Pages
- 31-39
- ISSN
- 1068-9583 (ISSN-L)
- 1573-3572
- OpenAlex
- W1985307995
- Cited by
- 190
- References
- 46
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 8 · 2022: 11 · 2021: 9 · 2020: 11 · 2019: 12 · 2018: 14 · 2017: 7 · 2016: 13 · 2015: 9 · 2014: 12 · 2013: 15 · 2012: 7
- FWCI
- 4.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Clinical Psychology in Medical Settings (publishedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- medication non-adherence, adolescent cancer patients, psychological risk factors, depression, self-esteem, family factors, trimethoprim-sulfamethoxazole, survival, mood
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