"These Drugs Are Going to Save Our Lives" A Mixed Methods Study on the Role of Medication Perceptions in Adherence to Oral Anticancer Agents Among Patients With Gastrointestinal Tract Cancer.

Abstract

Objective: Patients with gastrointestinal tract cancer reported suboptimal adherence to oral anticancer agents (OAAs), reducing the therapeutic benefit. According to the Common-Sense Model of Self-Regulation, patients' medication perceptions decide adherence. However, how perceptions of OAAs influence adherence remains unknown among this population. This study explored this relationship.

Methods: A convergent mixed methods study was conducted. In the quantitative part, medication perceptions were evaluated among 253 participants using the Beliefs about Medicines Questionnaire, Perceived Sensitivity to Medicine, and Self-efficacy for Appropriate Medication Use Scale. Adherence was measured by the Morisky 4-item Medication Adherence Scale. In the qualitative part, 37 participants from the quantitative cohort were interviewed concurrently. Perceptions of OAAs were identified using content analysis. Findings were integrated using side-by-side comparisons and joint displays.

Results: Quantitative data showed that 58.89% of patients were considered adherent. Adherent patients exhibited lower harm beliefs, less sensitivity to medicine, and higher medication self-efficacy. Qualitative data identified four categories of perceptions: emphasizing the effectiveness of OAAs despite the hazardous nature, experiencing negative emotions in relation to taking OAAs, taking responsibility for OAAs routine management, and encountering multiple barriers to taking OAAs. The qualitative findings supplemented the quantitative results regarding the associations between harm beliefs, perceived sensitivity to medicine, medication self-efficacy, and adherence; however, they revealed a discordance in the associations between necessity beliefs, concern beliefs, and adherence.

Conclusions: Strategies targeting medication perceptions were suggested to promote adherence to OAAs, particularly those aimed at modifying negative medication beliefs and emotions, enhancing medication self-efficacy, and improving self-management abilities.