Cognitive Disorders May Effect Adherence to Oral Medication

The creation and availability of oral oncolytics has rapidly changed the oncology world, and continues to do so, as more treatments are receiving FDA approval.

Because certain cancer treatments may now be administered by a patient in their own home instead of at a physician’s office, adherence is largely becoming the responsibility of the patient. To fight nonadherence, healthcare professionals involved with the patient, including oncologists, specialty pharmacists, and nurses, must be highly involved to ensure that they are taking their medication as prescribed, and not facing adverse health outcomes as a result of non-adherence.

Due to the sensitive nature of the condition, adherence to oral oncolytics is extremely important. However, some patients may stop treatment from a fear of side effects, or the regimen may be so complex they forget the instructions. Investigators in a study presented at the European Society for Medical Oncology Congress, found that cognitive disorders may affect adherence to oral cancer treatments.

This finding was especially significant among elderly patients.

“The objective of this initial study was to assess the relationship between cognitive functions and oral medication adherence in order to identify the patient profiles who are more likely to be non-adherent,” said researcher Florence Joly, MD, PhD.

Included in the study were 126 patients initiating treatment with oral oncolytics, half of whom were over 70-years-old. Prior to treatment, patients underwent neuropsychological tests that included an examination of autonomy, depression, and anxiety.

Investigators evaluated adherence through 2 self-reporting questionnaires and an observance sheet that was completed after undergoing treatment for 1 and 3 months. Approximately 50% of patients included in the study were defined as having global cognitive impairment.

They discovered that memory dysfunctions and depression were both associated with non-adherence. Nonadherence may cause increased costs for both the patient and the healthcare system, and may even negatively impact the efficacy of treatments and patient survival, according to the study.

These findings suggest that testing cognitive function prior to treatment initiation of oral cancer treatment may help healthcare professionals give patients the care they need. Since memory dysfunctions were commonly seen in elderly patients, it is important that those involved with treatment monitor these patients closely, and provide them with additional support.