医疗保健专业人员实施的干预措施对癌症患者口服靶向治疗依从性的影响：系统回顾和荟萃分析。

IF 2.8 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-01-17 DOI:10.1007/s00520-024-09136-4

Fiona Angus, Wan-Chuen Liao, Victoria Adekoya, Li-Chia Chen

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引用次数: 0

摘要

目的：本研究调查了医疗专业人员主导的干预措施对口服靶向治疗依从性的影响，并确定了支持干预措施的行为改变技术（bct）。方法：系统检索MEDLINE， Embase, APA PsycInfo, CINAHL Plus， PubMed和Web of Science，截至2024年7月，确定了随机对照试验和队列研究，涉及接受口服靶向治疗的成年癌症患者（≥18岁），接受医疗保健专业人员主导的干预以提高依从性。比较干预组和对照组（常规护理）之间的依从性相关结果，包括继续治疗或药物持有率(MPR)≥90%的患者比例。合并优势比（ORs）， 95%置信区间（ci）和异质性（I2统计）。在适用的情况下，计算和综合中位治疗停止时间的差异。采用BCT分类法对干预措施进行分类。结果：本综述纳入11项研究（1,654例患者）。继续治疗患者比例的汇总结果(OR 17.91；95%ci 3.18, 100.73；结论：尽管证据有限，但卫生保健专业人员主导的干预措施显著提高了治疗依从性。未来的研究应根据个人需求量身定制策略，并将bct应用于设计有效的干预措施。普洛斯彼罗登记了：没有。CRD42024571808。

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The effect of healthcare professional-implemented interventions on adherence to oral targeted therapy in patients with cancer: a systematic review and meta-analysis.

Purpose: This study investigated the impact of healthcare professional-led interventions on adherence to oral targeted therapy and identified the behavior change techniques (BCTs) underpinning the interventions.

Methods: A systematic search of MEDLINE, Embase, APA PsycInfo, CINAHL Plus, PubMed, and Web of Science up to July 2024 identified randomized controlled trials and cohort studies involving adult patients (≥ 18 years) with cancer on oral targeted therapy receiving healthcare professional-led interventions to improve adherence. Adherence-related outcomes, including proportions of patients continuing treatments or with a medication possession ratio (MPR) ≥ 90%, were compared between intervention and control (usual care) groups. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) and heterogeneity (I² statistic) were reported. Differences in median time to treatment discontinuation were calculated and synthesized where applicable. Interventions were categorized using the BCT taxonomy.

Results: This review included 11 studies (1,654 patients). The pooled results for proportions of patients continuing treatment (OR 17.91; 95%CI 3.18, 100.73; I² < 0.1%) or with an MPR ≥ 90% (OR 3.67; 95%CI 1.98, 6.80; I² < 0.1%) showed a significantly favorable outcome in the intervention group compared to the control group. In two studies, the median time to treatment discontinuation was longer in the intervention group than in the control group. The most commonly used BCTs were "credible source" (n = 11), "problem-solving" (n = 9), "instruction on how to perform a behavior" (n = 9), and "pharmacological support" (n = 8).

Conclusion: Despite limited evidence, healthcare professional-led interventions significantly improve treatment adherence. Future studies should tailor strategies for individual needs and apply BCTs in designing effective interventions. PROSPERO registered: no. CRD42024571808.

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.