Understanding Oral Anticancer Medication Adherence among Patients with Multiple Myeloma

项目总结 这份K23申请支持申请者的长期目标，即建立一个独立的、持续的 研究领先的以患者为中心的研究侧重于改善服药依从性和健康 不同社会经济状况的癌症患者的预后。癌症治疗进展，包括 昂贵的长期口服抗癌药物治疗延长了癌症患者的生存时间， 包括多发性骨髓瘤，一种威胁生命的血癌，与巨大的疼痛和 生活质量下降。提高对口服抗癌药物依从性如何影响患者的认识 随着时间的推移，健康结果以及经济困难可能如何影响这些关系，将为未来的大型- 规模研究，旨在开发及时、有针对性的干预措施，以提高依从性、减少疼痛和 提高癌症患者的生活质量。这项职业发展奖将支持申请人的 通过有重点的专家指导、课程作业和其他培训活动实现培训和研究目标 旨在1)发展特定于药物依从性研究的理论和测量知识；2) 发展开展纵向、混合方法研究所需的统计和定性方法专业知识； 以及3)获得深入的知识和研究技能，以便对弱势群体进行文化敏感研究 人口。拟议的研究项目将产生关于以下方面的时间关系的知识 开始长期口服抗癌药物患者的依从性、经济困难、疼痛和生活质量 多发性骨髓瘤。在90个社会经济样本中使用纵向、混合方法设计 多发性骨髓瘤患者新开口服抗癌维持治疗反复发作 在治疗开始后的基线、3个月和6个月进行测量评估，该研究的目标是1) 前瞻性确定口服抗癌药物依从性对疼痛和生活质量的影响；2) 确定经济困难是否会缓和口服抗癌药物之间的关系 随时间推移的依从性、疼痛和生活质量；3)探讨患者服用口服抗癌药物的经验 在不同依从性模式的参与者子集中使用定性方法进行药物治疗。描述性 将使用统计、混合效果建模和使用马尔可夫建模的滞后值效果来实现 目标分别为1和2。将使用定性描述和内容分析来实现目标3。 建议直接与国家护理研究所的使命一致，以了解行为 改善健康结果和生活质量的症状方面。埃默里大学的研究环境 提供强大的资源，将促进贝尔彻博士的职业发展成为独立的研究 科学家。

PROJECT SUMMARY This K23 application support's the applicant's long-term goal to build an independent, sustained program of research leading patient-oriented research studies focused on improving medication adherence and health outcomes among socioeconomically diverse patients with cancer. Cancer treatment advances, including costly, long-term therapy with oral anticancer medication, have extended survival for patients with cancer, including those with multiple myeloma, a life-threatening blood cancer associated with significant pain and reduced quality of life. Improved knowledge of how oral anticancer medication adherence influences patient health outcomes over time and how financial hardship may affect these relationships will inform future large- scale studies aimed at developing timely, targeted interventions to improve adherence, reduce pain, and improve quality of life in patients with cancer. This career development award will support the applicant's training and research goals through focused, expert mentorship, coursework, and other training activities designed to 1) develop theoretical and measurement knowledge specific to medication adherence research; 2) develop statistical and qualitative methods expertise needed to conduct longitudinal, mixed method research; and 3) gain in-depth knowledge and research skills to conduct culturally-sensitive research with vulnerable populations. The proposed research project will generate knowledge about temporal relationships among adherence, financial hardship, pain, and quality of life in patients initiating long-term oral anticancer medication for multiple myeloma. Utilizing a longitudinal, mixed method design in a sample of 90 socioeconomically diverse patients newly prescribed oral anticancer maintenance therapy for multiple myeloma with repeated measure assessment at baseline, 3-months, and 6-months post therapy initiation, the study aims to 1) prospectively determine the influence of oral anticancer medication adherence on pain and quality of life; 2) determine whether financial hardship moderates the relationship between oral anticancer medication adherence and pain and quality of life over time; and 3) explore the patient experience of taking oral anticancer medication using qualitative methods in a subset of participants with differing adherence patterns. Descriptive statistics, mixed-effects modeling, and lagged value effects using Markov modeling will be used to achieve aims 1 and 2, respectively. Qualitative description and content analysis will be used to achieve aim 3. This proposal directly aligns with the National Institute of Nursing Research's mission to understand the behavioral aspects of symptoms to improve health outcomes and quality of life. Emory University's research environment provides strong resources that will facilitate Dr. Belcher's career development into an independent research scientist.