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采用社区癌症诊所中的简短措施评估慢性髓性白血病患者的口服化疗不依从性:一项初步研究。

Assessment of Oral Chemotherapy Nonadherence in Chronic Myeloid Leukemia Patients Using Brief Measures in Community Cancer Clinics: A Pilot Study.

机构信息

Department of Medicine, Louisiana State University Health-Shreveport, Shreveport, LA 71130, USA.

Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA.

出版信息

Int J Environ Res Public Health. 2021 Oct 21;18(21):11045. doi: 10.3390/ijerph182111045.

Abstract

The purpose of this pilot study was to assess Chronic Myeloid Leukemia (CML) patients' adherence to, beliefs about, and barriers to oral anticancer agents (OAC) using brief self-report measures in community-based cancer clinics. Patients completed a structured interview including a health literacy assessment, a Brief Medication Questionnaire, two single-item self-report adherence questions, and the Medications Adherence Reasons Scale. Of the 86 participants, 88.4% were white; 55.8% male; mean age, 58.7 years; and 22.1% had limited health literacy. Nonadherence (missing at least one dose in the last week) was reported by 18.6% of participants and associated ( < 0.003) with less-than-excellent perceived ability to take CML medications (16.3%). Black participants reported more difficulty taking CML medications than white participants (28.6% vs. 8.3%, = 0.053). Among all participants, 43.0% reported their CML medicine was ineffective and 24.4% that taking CML pills was somewhat to very hard. The most common reasons for missing a dose were simply missed it (24.4%) and side effects (18.6%). Most patients perceived their ability to take CML medication was good to excellent, yet nearly one in five reported missing at least one dose in the last week. Brief, no-cost self-report assessments to screen CML patients' OAC adherence, barriers, and beliefs could facilitate counseling in busy community cancer clinics.

摘要

本初步研究旨在通过在社区癌症诊所使用简短的自我报告措施,评估慢性髓性白血病 (CML) 患者对口服抗癌药物 (OAC) 的依从性、信念和障碍。患者完成了一项结构化访谈,包括健康素养评估、简短药物问卷、两个单项自我报告依从性问题和药物依从性原因量表。在 86 名参与者中,88.4%为白人;55.8%为男性;平均年龄为 58.7 岁;22.1%的人健康素养有限。18.6%的参与者报告存在不依从性(在过去一周内漏服至少一剂),且与较差的(<0.003)自我感知服用 CML 药物的能力有关(16.3%)。黑人参与者报告服用 CML 药物比白人参与者更困难(28.6%比 8.3%, = 0.053)。在所有参与者中,43.0%的人报告 CML 药物无效,24.4%的人认为服用 CML 药丸有点到非常困难。错过剂量的最常见原因是简单地错过了(24.4%)和副作用(18.6%)。大多数患者认为自己服用 CML 药物的能力良好至优秀,但近五分之一的人报告在过去一周内漏服至少一剂。简短、无成本的自我报告评估可以筛选 CML 患者的 OAC 依从性、障碍和信念,从而促进繁忙的社区癌症诊所的咨询。

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