Abstract
BackgroundHealthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the management of medication adherence.MethodsA cross-sectional, observational study among HCPs in (haemato-)oncology settings in Belgium and the Netherlands was conducted in 2014 using a composite questionnaire. A total of 47 care activities were listed and categorised into eight domains. HCPs were also asked about their perceptions of adherence management on the items: insight into adherence, patients’ communication, capability to influence, knowledge of consequences and insight into causes. Validated questionnaires were used to assess beliefs about medication (BMQ) and shared decision making (SDM-Q-doc).ResultsIn total, 208 HCPs (29% male) participated; 107 from 51 Dutch and 101 from 26 Belgian hospitals. Though a wide range of activities were reported, certain domains concerning medication adherence management received less attention. Activities related to patient knowledge and adverse event management were reported most frequently, whereas activities aimed at patient’s self-efficacy and medication adherence during ongoing use were frequently missed. The care provided differed between professions and by country. Belgian physicians reported more activities than Dutch physicians, whereas Dutch nurses and pharmacists reported more activities than Belgian colleagues. The perceptions of medication adherence management were related to the level of care provided by HCPs. SDM and BMQ outcomes were not related to the care provided.ConclusionsEnhancing the awareness and perceptions of medication adherence management of HCPs is likely to have a positive effect on care quality. Care can be improved by addressing medication adherence more directly e.g., by questioning patients about (expected) barriers and discussing strategies to overcome them, by asking for missed doses and offering (electronic) reminders to support long-term medication adherence. A multidisciplinary approach is recommended in which the role of the pharmacist could be expanded.
Highlights
Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence
The usual care sum scores of HCPs in the Netherlands and in Belgium were compared for all professions by means of the non-parametric Mann Whitney test for nurse practitioners and the T-test for all other professions
The present study provides an extensive survey of care activities performed by a variety of HCPs including physicians, nurse practitioners, nurses and pharmacists aimed to support adherence to oral anticancer agents (OACA) treatment
Summary
Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the management of medication adherence. Due to the availability of rapidly growing numbers of new oral anticancer agents (OACA) directed towards specific tumour cell targets, in (haemato-)oncology medication adherence is becoming an increasingly important issue [1]. Non-adherence to medication is a complex and multidimensional healthcare problem. Adherence is defined as the extent to which a patient follows agreed recommendations for prescribed treatments [4]. Patients may intentionally or unintentionally be non-adherent during different stages of their treatment [5, 6]. Regarding adherence to OACA, rates between 16 and 100% have been reported [8]
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