Oral oncolytic treatments can be complex and often costly for payers and patients. Researchers conducted a literature review to assess patient-related factors impacting medication adherence to oral oncolytics and observed four common barriers to adherence: negative health and medication belief (34%); lack of knowledge and negative perceived risk and benefit associated with disease treatment (21%); increased psychosocial stress, anxiety, anger, fear, or frustration with health care professionals or the health care system (21%); and forgetfulness (17%).
The results of the study were presented during AMCP Nexus 2020 Virtual in a poster presentation titled “Patient-Related Factors: A Prevalent Barrier Dimension in Adherence to Oral Oncolytic Treatments Literature Review.”
Researchers conducted a literature review for oral oncolytic treatments from 2014 to 2019. Twenty-one of the patient-related barriers categorized using the World Health Organization classification for oral oncolytic treatments were ranked by type, prevalence, and impact on adherence. Outcomes for adherence were defined by in-person or phone interviews, Chew’s health literacy questionnaires, various surveys, claims data analysis, prescription refill data, and assessment scales such as the Memorial Symptom Assessment Scale and Morisky Medication Adherence Scale.
The final analysis included 24articles; among them, patient-related adherence barriers were consistent across 13 of the 21 factors.
Impact of negative health and medication belief decreased adherence by 30% to 89% across the studies. Forgetfulness decreased adherence by a range of 30% to 47%, while lack of knowledge and negative perceived risk and benefit associated with disease and treatment had a larger variation with negative impact on adherence, ranging from 9.5% to 80.0%. Increased psychosocial stress, anxiety, anger, fear, or frustration with health care professionals or the health care system reported a range of 35.0% to 60.8% in decreased adherence. Many studies did not achieve statistically significant adherence outcomes that directly impacted treatment safety, efficacy, or cost.
“Almost one-half of the patient-related barriers to medication adherence are psychological/behavioral and can be positively impacted by implementing patient-centric interventions,” the researchers concluded. “While physical factors like age and gender cannot be readily modified, targeted interventions at older populations or a specific gender (based on current research findings) may prove beneficial when seeking to improve medication adherence and patient outcomes. When developing medication adherence strategies for oral oncolytic treatments, health care practitioners should consider addressing patient-related factors that can be modified to create effective long-term results.”
Shah RY, Sadosky A, Ambegaonkar A. Patient-Related Factors: A Prevalent Barrier Dimension in Adherence to Oral Oncolytic Treatments Literature Review. Poster U38. AMCP Nexus 2020 Virtual.