Disparities and challenges in adherence to oral antineoplastic agents

Accordino, Melissa K.; Hershman, Dawn L.

doi:10.14694/edbook_am.2013.33.271

Cited by 40Medication Adherence and CompliancePharmacy and Medical PracticesCancer survivorship and care

Disparities and challenges in adherence to oral antineoplastic agents

Accordino, Melissa K., Hershman, Dawn L.·2013·American Society of Clinical Oncology Educational Book

DOI 10.14694/edbook_am.2013.33.271

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Abstract

The issue of medication noncompliance is becoming increasingly important in oncology as more cancer therapies are delivered orally. Medication adherence is difficult to assess and there is no gold standard of measurement. The act of measuring adherence can affect outcomes. Medication noncompliance is common, and is estimated to be 50% in treatment of chronic diseases. Studies have shown that women initiate adjuvant hormonal therapy for breast cancer 64% to 88% of the time when prescribed. Of those who initiate therapy, 50% to 80% are adherent for the prescribed duration, depending on the study. Patients noncompliant with adjuvant hormonal therapy for breast cancer have worse overall survival than their counterparts. Suboptimal treatment responses in chronic myeloid leukemia (CML) are also associated with medication noncompliance. Poor adherence can also affect clinical trial results, leading to inaccuracies of treatment efficacy. Barriers to compliance can occur on the individual, cultural, or system level. Examples of specific barriers are side effects, cost and access to medication, and individual health beliefs. Specific populations, including racial minorities, elderly patients, and very young patients, may be at higher risk for medication noncompliance. Strategies to improve compliance are multifactorial and include improvement of patient education, reduction of treatment side effects, interventions to alter behavior, and changes in public policy to improve financial barriers to treatment. Technology has been an effective tool in improving compliance in noncancer-related illness, and ongoing studies are evaluating its role in the oncology population.

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There is no gold standard for measuring adherence because of accuracy limitations of assessment methods.
“Due to the accuracy limitations of the methods to assess adherence (e.g., self-report, pill counts, pharmacy records, medical records, electronic medication caps),11 there is no gold standard for measuring adherence.12-14”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [12]

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Authors: Accordino, M. K., & Hershman, D. L.
Affiliations: Columbia University Irving Medical Center (US)
ORCID: Accordino, Melissa K.
Hershman, Dawn L.
Venue: American Society of Clinical Oncology Educational Book
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2013-05
Volume: 33
Issue: 33
Pages: 271-276
ISSN: 1548-8748 (ISSN-L)
1548-8756
DOI: 10.14694/edbook_am.2013.33.271
OpenAlex: W2041068420
Cited by: 40
References: 26
Citations by year: 2026: 2 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 11 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 5 · 2016: 5 · 2015: 1 · 2014: 4 · 2013: 1
FWCI: 3.16
Type: journal article
Language: en
Open access: closed
Locations: American Society of Clinical Oncology Educational Book (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords: medication adherence, medication non-adherence, oral anticancer drugs, adjuvant endocrine therapy, breast cancer, chronic myeloid leukemia, barriers to adherence, health beliefs, treatment side effects, racial minorities, elderly patients, patient education
MeSH terms: Administration, Oral, Age Factors, Antineoplastic Agents, Breast Neoplasms, Female, Humans, Patient Compliance, Patient Education as Topic, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Treatment Outcome

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Disparities and challenges in adherence to oral antineoplastic agents

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