Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents
Yun Jiang,1 Karen E Wickersham,2 Xingyu Zhang,1 Debra L Barton,1 Karen B Farris,3 John C Krauss,4 Marcelline R Harris1 1University of Michigan School of Nursing, Ann Arbor, MI, USA; 2University of South Carolina College of Nursing, Columbia, SC, USA; 3University of Michigan College of Pharmacy, Ann...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2020-01-01
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| Series: | Patient Preference and Adherence |
| Subjects: | |
| Online Access: | https://www.dovepress.com/side-effects-self-management-activities-and-adherence-to-oral-anticanc-peer-reviewed-article-PPA |
| _version_ | 1818554205642686464 |
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| author | Jiang Y Wickersham KE Zhang X Barton DL Farris KB Krauss JC Harris MR |
| author_facet | Jiang Y Wickersham KE Zhang X Barton DL Farris KB Krauss JC Harris MR |
| author_sort | Jiang Y |
| collection | DOAJ |
| description | Yun Jiang,1 Karen E Wickersham,2 Xingyu Zhang,1 Debra L Barton,1 Karen B Farris,3 John C Krauss,4 Marcelline R Harris1 1University of Michigan School of Nursing, Ann Arbor, MI, USA; 2University of South Carolina College of Nursing, Columbia, SC, USA; 3University of Michigan College of Pharmacy, Ann Arbor, MI, USA; 4University of Michigan Medical School, Michigan Medicine, Ann Arbor, MI, USACorrespondence: Yun JiangUniversity of Michigan School of Nursing, 400 North Ingalls Street, Ann Arbor, MI 48109, USAEmail jiangyu@umich.eduPurpose: There are growing concerns about patients’ adherence to oral anticancer agents (OAAs), and the need for patients to engage in self-management of OAA-related side effects. We assessed associations among adherence, severity of side effects, and effectiveness of self-management of side effects in patients taking capecitabine.Methods: Adherence to capecitabine at 6 weeks was measured by the Medication Event Monitoring System among 50 patients with gastrointestinal cancers. Severity of side effects related to capecitabine and effectiveness of self-management of side effects were captured using the Modified Self-Care Diary at the time of enrollment and weekly for 6 weeks. Spearman’s correlation, Mann–Whitney U-tests, and multiple linear regression were conducted, p<0.05.Results: Overall mean adherence rate was 85.4±14.1%. Adherence rate was not significantly correlated to the mean severity of total side effects at any time point and was correlated with the mean effectiveness of self-management of total side effects only at week 2 (rho=0.29, p=0.04). However, adherence rate was associated with the mean severity of one specific side effect, diarrhea, at 6 weeks (rho=0.36, p=0.01) and marginally correlated to the mean effectiveness of self-management of diarrhea at 6 weeks (rho=0.28, p=0.05). Mean severity of diarrhea at 6 weeks was an independent predictor of adherence rate (b=4.97, p=0.01), with the control of age (b=0.52, p=0.002), number of outpatient medications (b=1.12, p=0.007), health literacy (b=2.53, p=0.04), diagnosis of colorectal cancer (b=11.6, p=0.03), and capecitabine in combination with other chemotherapies (b=16.8, p=0.001) in the model.Conclusion: This pilot study suggests ongoing examination of both severity and effectiveness of self-management of side effects in future studies of adherence to OAAs is merited. There is a need for future studies with larger sample sizes that explore the complex relationships among adherence, severity of side effects, and effectiveness of self-management of side effects in OAA therapy.Keywords: oral anticancer agents, adherence, side effects, self-management |
| first_indexed | 2024-12-12T09:36:18Z |
| format | Article |
| id | doaj.art-c179a442e3614d08acddaa3f25c19a34 |
| institution | Directory Open Access Journal |
| issn | 1177-889X |
| language | English |
| last_indexed | 2024-12-12T09:36:18Z |
| publishDate | 2020-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Patient Preference and Adherence |
| spelling | doaj.art-c179a442e3614d08acddaa3f25c19a342022-12-22T00:28:43ZengDove Medical PressPatient Preference and Adherence1177-889X2020-01-01Volume 132243225250829Side Effects, Self-Management Activities, and Adherence to Oral Anticancer AgentsJiang YWickersham KEZhang XBarton DLFarris KBKrauss JCHarris MRYun Jiang,1 Karen E Wickersham,2 Xingyu Zhang,1 Debra L Barton,1 Karen B Farris,3 John C Krauss,4 Marcelline R Harris1 1University of Michigan School of Nursing, Ann Arbor, MI, USA; 2University of South Carolina College of Nursing, Columbia, SC, USA; 3University of Michigan College of Pharmacy, Ann Arbor, MI, USA; 4University of Michigan Medical School, Michigan Medicine, Ann Arbor, MI, USACorrespondence: Yun JiangUniversity of Michigan School of Nursing, 400 North Ingalls Street, Ann Arbor, MI 48109, USAEmail jiangyu@umich.eduPurpose: There are growing concerns about patients’ adherence to oral anticancer agents (OAAs), and the need for patients to engage in self-management of OAA-related side effects. We assessed associations among adherence, severity of side effects, and effectiveness of self-management of side effects in patients taking capecitabine.Methods: Adherence to capecitabine at 6 weeks was measured by the Medication Event Monitoring System among 50 patients with gastrointestinal cancers. Severity of side effects related to capecitabine and effectiveness of self-management of side effects were captured using the Modified Self-Care Diary at the time of enrollment and weekly for 6 weeks. Spearman’s correlation, Mann–Whitney U-tests, and multiple linear regression were conducted, p<0.05.Results: Overall mean adherence rate was 85.4±14.1%. Adherence rate was not significantly correlated to the mean severity of total side effects at any time point and was correlated with the mean effectiveness of self-management of total side effects only at week 2 (rho=0.29, p=0.04). However, adherence rate was associated with the mean severity of one specific side effect, diarrhea, at 6 weeks (rho=0.36, p=0.01) and marginally correlated to the mean effectiveness of self-management of diarrhea at 6 weeks (rho=0.28, p=0.05). Mean severity of diarrhea at 6 weeks was an independent predictor of adherence rate (b=4.97, p=0.01), with the control of age (b=0.52, p=0.002), number of outpatient medications (b=1.12, p=0.007), health literacy (b=2.53, p=0.04), diagnosis of colorectal cancer (b=11.6, p=0.03), and capecitabine in combination with other chemotherapies (b=16.8, p=0.001) in the model.Conclusion: This pilot study suggests ongoing examination of both severity and effectiveness of self-management of side effects in future studies of adherence to OAAs is merited. There is a need for future studies with larger sample sizes that explore the complex relationships among adherence, severity of side effects, and effectiveness of self-management of side effects in OAA therapy.Keywords: oral anticancer agents, adherence, side effects, self-managementhttps://www.dovepress.com/side-effects-self-management-activities-and-adherence-to-oral-anticanc-peer-reviewed-article-PPAoral anticancer agentsadherenceside effectsself-management |
| spellingShingle | Jiang Y Wickersham KE Zhang X Barton DL Farris KB Krauss JC Harris MR Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents Patient Preference and Adherence oral anticancer agents adherence side effects self-management |
| title | Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents |
| title_full | Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents |
| title_fullStr | Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents |
| title_full_unstemmed | Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents |
| title_short | Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents |
| title_sort | side effects self management activities and adherence to oral anticancer agents |
| topic | oral anticancer agents adherence side effects self-management |
| url | https://www.dovepress.com/side-effects-self-management-activities-and-adherence-to-oral-anticanc-peer-reviewed-article-PPA |
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