Re: Adherence to Therapy With Oral Antineoplastic Agents

Abstract

With the rise in availability and increasing use of oral anti- cancer agents, concerns about adherence to prescribed regi- mens will become an increasingly important issue in oncol- ogy. Few published studies have focused on adherence to oral antineoplastic therapy, in part because the vast majority of chemotherapy is delivered intravenously in physicians’ offices or hospitals. In this article, we review current knowl- edge of adherence behavior with regard to oral medications in general, including factors associated with adherence and methods for measuring adherence. We also review published studies of adherence to oral antineoplastic agents in adult and pediatric populations and adherence issues in cancer prevention. The available evidence reveals that patient ad- herence to oral chemotherapy recommendations is variable and not easily predicted. Adherence rates ranging from less than 20% to 100% have been reported, and certain popula- tions, such as adolescents, pose particular challenges. Future efforts should focus on improving measurement and predic- tion of adherence and on developing interventions to im- prove adherence for both patients in clinical trials and patients being treated outside of the research setting. Assessment of adherence among individuals with cancer and implementa- tion of interventions in situations of poor adherence should improve clinical outcomes. [J Natl Cancer Inst 2002;94:652– 61]