成人胃肠道癌症患者口服抗癌药物的依从性:一项范围综述。

IF 2.4 3区 医学 Q1 NURSING
Yongfeng Chen, Marques Shek Nam Ng, Mengyue Zhang, Carmen Wing Han Chan
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引用次数: 0

摘要

背景:胃肠道癌症患者报告口服抗癌药物(OAAs)依从性不佳,降低了治疗效果,增加了死亡风险。范围审查可以全面绘制关于OAAs依从性的现有证据,并为改善治疗结果提供适当的支持。目的:本研究的目的是对成人胃肠道癌患者的oaa依从性研究进行综合分析,包括依从率、不依从性原因、影响因素、管理策略和指导这些研究的理论。方法:采用系统评价和荟萃分析首选报告项目,扩展范围评价清单和范围评价的五阶段方法框架。根据5个研究问题,系统检索7个数据库,检索同行评议的原创研究,并进行叙事综合。结果:纳入52项研究。依从性从16.7%到100%不等,自我报告的中位率为68%。研究确定了七类不坚持治疗的原因,其中最常见的是不良反应、癌症进展、患者拒绝和健忘。此外,还确定了40多个影响因素。它们与患者、疾病状况、治疗、社会经济和卫生保健系统有关。教育和后续护理是管理策略的主要组成部分,但效果不一致。目前,52项研究中只有3项采用了理论框架。结论:成人胃肠道癌患者坚持服用OAAs的情况并不理想。未来的研究需要严谨的设计和理论框架来制定增强依从性的策略和解释理论机制。对实践的启示:建议采取常规评估和预防措施来延迟可改变的不依从。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adherence to Oral Anticancer Agents Among Adults With Gastrointestinal Tract Cancer: A Scoping Review.

Background: Patients with gastrointestinal tract cancer reported suboptimal adherence to oral anticancer agents (OAAs), reducing their therapeutic benefit and increasing mortality risk. A scoping review can comprehensively map available evidence on adherence to OAAs and inform appropriate support to improve treatment outcomes.

Objective: The aim of this study was to comprehensively map studies on adherence to OAAs among adults with gastrointestinal tract cancer, including the adherence rate, nonadherence reasons, influential factors, management strategies, and theories that guide these studies.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist and the 5-stage methodological framework of scoping review were followed. According to the 5 research questions, 7 databases were systematically searched for peer-reviewed original studies, and a narrative synthesis was performed.

Results: Fifty-two studies were included. Adherence ranged from 16.7% to 100%, giving a median rate of 68% by self-report. Seven categories of nonadherence reasons were identified, with adverse effects, cancer progression, patient refusal, and forgetfulness being most frequently reported. Furthermore, more than 40 influential factors were identified. They are related to patient, disease condition, therapy, socioeconomic, and healthcare-system dimensions. Education and follow-up care were the main components of management strategies, but the effectiveness was inconsistent. Currently, only 3 of 52 studies adopted theoretical frameworks.

Conclusion: Adherence to OAAs among adults with gastrointestinal tract cancer is suboptimal. Future studies with rigorous designs and theoretical frameworks are needed to develop adherence-enhancing strategies and explain theoretical mechanisms.

Implications for practice: Routine assessments and preventive actions are suggested to delay modifiable nonadherence.

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来源期刊
Cancer Nursing
Cancer Nursing 医学-护理
CiteScore
4.80
自引率
3.80%
发文量
244
审稿时长
6-12 weeks
期刊介绍: Each bimonthly issue of Cancer Nursing™ addresses the whole spectrum of problems arising in the care and support of cancer patients--prevention and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, psychosocial aspects of cancer, patient responses to all treatment modalities, and specific nursing interventions. The journal offers unparalleled coverage of cancer care delivery practices worldwide, as well as groundbreaking research findings and their practical applications.
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