Investigation of Intervention Solutions to Enhance Adherence to Oral Anticancer Medicines in Adults: Overview of Reviews

Thu Ha Dang; Abdur Rahim Mohammad Forkan; Nilmini Wickramasinghe; Prem Prakash Jayaraman; Marliese Alexander; Kate Burbury; Penelope Schofield

doi:10.2196/34833

Investigation of Intervention Solutions to Enhance Adherence to Oral Anticancer Medicines in Adults: Overview of Reviews

JMIR Cancer. 2022 Apr 27;8(2):e34833. doi: 10.2196/34833.

Authors

Thu Ha Dang^{1

2

3}, Abdur Rahim Mohammad Forkan⁴, Nilmini Wickramasinghe^{5

6}, Prem Prakash Jayaraman⁴, Marliese Alexander^{7

8}, Kate Burbury^{8

9}, Penelope Schofield^{2

8

10}

Affiliations

¹ Department of Psychology, School of Health Sciences, Swinburne University of Technology, Melbourne, Australia.
² Behavioural Sciences Unit, Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia.
³ Digital Health Cooperative Research Centre, Sydney, Australia.
⁴ Digital Innovation Lab, School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Melbourne, Australia.
⁵ Department Health and Bio Statistics, School of Health Sciences and Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia.
⁶ Epworth Healthcare, Melbourne, Australia.
⁷ Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Australia.
⁸ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia.
⁹ Digital and Healthcare Innovation, Peter McCallum Cancer Centre, Melbourne, Australia.
¹⁰ Department of Psychology, and Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Australia.

PMID: 35475978
PMCID: PMC9096640
DOI: 10.2196/34833

Abstract

Background: Adherence to anticancer medicines is critical for the success of cancer treatments; however, nonadherence remains challenging, and there is limited evidence of interventions to improve adherence to medicines in patients with cancer.

Objective: This overview of reviews aimed to identify and summarize available reviews of interventions to improve adherence to oral anticancer medicines in adult cancer survivors.

Methods: A comprehensive search of 7 electronic databases was conducted by 2 reviewers who independently conducted the study selection, quality assessment using the A Measurement Tool to Assess Systematic Reviews 2, and data extraction. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist was adapted to report the results.

Results: A total of 29 reviews were included in the narrative synthesis. The overall quality of the systematic reviews was low. The 4 main strategies to promote adherence were focused on education, reminders, behavior and monitoring, and multicomponent approaches. Digital technology-based interventions were reported in most reviews (27/29, 93%). A few interventions applied theories (10/29, 34%), design frameworks (2/29, 7%), or engaged stakeholders (1/29, 3%) in the development processes. The effectiveness of interventions was inconsistent between and within reviews. However, interventions using multiple strategies to promote adherence were more likely to be effective than single-strategy interventions (12/29, 41% reviews). Unidirectional communication (7/29, 24% reviews) and technology alone (11/29, 38% reviews) were not sufficient to demonstrate improvement in adherence outcomes. Nurses and pharmacists played a critical role in promoting patient adherence to oral cancer therapies, especially with the support of digital technologies (7/29, 24% reviews).

Conclusions: Multicomponent interventions are potentially effective in promoting patient adherence to oral anticancer medicines. The seamless integration of digital solutions with direct clinical contacts is likely to be effective in promoting adherence. Future research for developing comprehensive digital adherence interventions should be evidence-based, theory-based, and rigorously evaluated.

Keywords: digital; intervention; medication adherence; oncology; oral anticancer; systematic review.

©Thu Ha Dang, Abdur Rahim Mohammad Forkan, Nilmini Wickramasinghe, Prem Prakash Jayaraman, Marliese Alexander, Kate Burbury, Penelope Schofield. Originally published in JMIR Cancer (https://cancer.jmir.org), 27.04.2022.

Publication types

Review