Adherence to oral chemotherapy: Challenges and opportunities
Adherence to oral chemotherapy: Challenges and opportunities
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DOI：
10.1177/1078155218800384
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发表时间：
2019-10-01
影响因子：
1.3
通讯作者：
Weissmann, Lisa
中科院分区：
文献类型：
--
作者：
Krikorian, Susan;Pories, Susan;Weissmann, Lisa
目的：关于联合使用各种方法以更好地预测和改善癌症患者口服避孕药依从性的效果的数据很少。本研究的目的是评价在口服降糖药治疗开始时强化药剂师干预与护士主导的对照组对依从性的有效性。方法：这是一项前瞻性、随机、开放标签对照试验，在单中心血液学/肿瘤学门诊进行，比较重复药师教育干预对处方口服抗肿瘤药物后4周和8周测量的依从率的有效性，并与护士领导的对照组进行比较。两组均包括研究者药丸计数和自我报告依从性问卷。结果2009年至2015年期间入组了200例患者。药剂师组101例患者中的14例（14%）和护士领导的对照组99例患者中的7例（7%）退出（p = 0.166）。在两组中，仍留在研究中的大多数患者对口服降糖药的依从性为90-100%。药剂师组在药丸计数2时表现略差，可能是由于不依从的障碍。与不依从性相关的统计学显著相关性为健忘（p = 0.009），希望避免副作用（p = 0.02），感到沮丧或不知所措（p = 0.032），或在两组中服药前入睡（p = 0.048）。结论将服药次数与患者自我报告依从性相结合是提高口服避孕药依从性的一种方法。然而，发现了依从性的重大障碍，如健忘，希望避免副作用，感到沮丧或不知所措，以及在服药前入睡。
Purpose There is very little data on the effect of combining methods to better predict and improve oral antineoplastic adherence in cancer patients. The goal of this study was to evaluate the effectiveness of an intensive pharmacist intervention at the beginning of oral antineoplastic therapy versus nurse-led control group on adherence. Methods This was a prospective, randomized, open-label controlled trial performed in a single center hematology/oncology outpatient service to compare the effectiveness of repetitive pharmacist educational intervention on adherence rates measured at four and eight weeks after prescribing oral antineoplastic medication compared to a nurse-led control group. Both groups included investigator pill counts and self-report adherence questionnaires. Results Two-hundred patients were enrolled between 2009 and 2015. Fourteen of the 101 (14%) patients in the pharmacist group and 7 (7%) of the 99 patients in the nurse-led control group dropped out (p = 0.166). The majority of patients who remained in the study were 90-100% adherent to oral antineoplastic therapy in both groups. The pharmacist group slightly underperformed at Pill Count 2, possibly due to barriers for non-adherence. Statistically significant correlations associated with non-adherence were forgetfulness (p = 0.009), wanting to avoid side effects (p = 0.02), feeling depressed or overwhelmed (p = 0.032), or falling asleep before taking medication (p = 0.048) in both groups. Conclusion The combination of pill count and patient self-report adherence is a way of improving oral antineoplastic adherence. However, significant barriers to adherence were identified such as forgetfulness, wanting to avoid side effects, feeling depressed or overwhelmed, and falling asleep before taking medications.