Adherence influencing factors in patients taking oral anticancer agents: A systematic review
Adherence influencing factors in patients taking oral anticancer agents: A systematic review
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DOI：
10.1016/j.canep.2014.03.012
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发表时间：
2014-06-01
影响因子：
2.6
通讯作者：
Eikermann, Michaela
中科院分区：
文献类型：
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作者：
Mathes, Tim;Pieper, Dawid;Eikermann, Michaela
背景：过去几十年来，口服抗癌药物的使用稳步增长。尽管口服抗癌药物的依从性对于治疗的成功很重要，但许多患者的依从性不够。目的：评估服用口服抗癌药物的患者依从性的影响因素。方法：在Medline和Embase中进行系统文献检索。标题和摘要以及相关的全文均根据预定义的纳入标准进行筛选。评估了偏倚风险。两者均由两名评审员独立进行。研究特征和结果的相关数据由一名评审员在标准化表格中提取，并由另一名评审员进行检查。由于研究之间的临床和方法学异质性，未进行荟萃分析，以避免误导结果。使用标准化程序以叙述方式综合数据。结果：确定了 22 项相关研究。研究质量中等。特别是影响因素和依从性测量的偏倚风险大多不清楚。社会支持、芳香酶抑制剂的摄入以及 OACA 较低的自付费用似乎对依从性产生积极影响。抑郁症和不同药物的数量似乎对依从性产生负面影响。低年龄和高年龄似乎与较低的依从性相关。其余因素大多没有影响，或者在效果方向和统计显着性方面存在异质性。结论：有一些因素似乎对服用 OACA 的患者的依从性有影响。然而，由于异质性，无法对这些可应用于所有适应症、药物、环境、国家等的因素得出一般性结论。结果应被视为可能影响 OACA 依从性的因素的指示。 (C) 2014 Elsevier Ltd. 保留所有权利。
Background: The use of oral anticancer agents increased steadily in the last decades. Although oral anticancer agent adherence is important for a successful treatment, many patients are insufficiently adherent.Purpose: To evaluate adherence influencing factors in patients taking oral anticancer agents.Methods: A systematic literature search was performed in Medline and Embase. Titles and abstracts and in case of relevance, full-texts were screened according to predefined inclusion criteria. The risk of bias was assessed. Both were carried out independently by two reviewers. Relevant data on study characteristics and results were extracted in standardized tables by one reviewer and checked by a second. A meta-analysis was not performed because of clinical and methodological heterogeneity between the studies to avoid misleading results. Data were synthesized in narrative way using a standardized procedure.Results: Twenty-two relevant studies were identified. The study quality was moderate. Especially the risk of bias regarding the measurement of influencing factors and adherence was mostly unclear. Social support, intake of aromatase inhibitors, and lower out-of-pocket costs for OACA seem to have a positive effect on adherence. Depression and the number of different medications seem to have a negative effect on adherence.Low age and very high age seem to be associated with lower adherence.The remaining factors showed either mostly no influence or were heterogeneous regarding the effect direction and statistical significance.Conclusions: There are some factors that seem to have influence on adherence in patients taking OACA. However, due to the heterogeneity no general conclusions can be made also for these factors that can be applied to all indications, medications, settings, countries etc. The results should rather be considered as indications for factors that can have an influence on adherence to OACA. (C) 2014 Elsevier Ltd. All rights reserved.