Partridge Ann H, Avorn Jerry, Wang Philip S, Winer Eric P
Dana-Farber Cancer Institute, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
J Natl Cancer Inst. 2002 May 1;94(9):652-61. doi: 10.1093/jnci/94.9.652.
With the rise in availability and increasing use of oral anticancer agents, concerns about adherence to prescribed regimens will become an increasingly important issue in oncology. 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 knowledge 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 adherence to oral chemotherapy recommendations is variable and not easily predicted. Adherence rates ranging from less than 20% to 100% have been reported, and certain populations, such as adolescents, pose particular challenges. Future efforts should focus on improving measurement and prediction of adherence and on developing interventions to improve adherence for both patients in clinical trials and patients being treated outside of the research setting. Assessment of adherence among individuals with cancer and implementation of interventions in situations of poor adherence should improve clinical outcomes.
随着口服抗癌药物的可及性增加以及使用增多，对于遵循规定治疗方案的担忧在肿瘤学领域将成为一个日益重要的问题。很少有已发表的研究聚焦于口服抗肿瘤治疗的依从性，部分原因是绝大多数化疗是在医生办公室或医院通过静脉给药。在本文中，我们综述了关于一般口服药物依从行为的现有知识，包括与依从性相关的因素以及测量依从性的方法。我们还综述了已发表的关于成人和儿童群体口服抗肿瘤药物依从性以及癌症预防中依从性问题的研究。现有证据表明，患者对口服化疗建议的依从性参差不齐且难以预测。已报道的依从率从低于20%到100%不等，某些人群，如青少年，面临着特殊挑战。未来的工作应集中在改进依从性的测量和预测，以及开发干预措施以提高临床试验患者和非研究环境下接受治疗患者的依从性。评估癌症患者的依从性并在依从性差的情况下实施干预措施应能改善临床结局。
