Affiliation:
1. From the Centre for Medical Psychology and Evidence-Based Decision-Making; and Psycho-Oncology Co-operative Research Group, University of Sydney; Consultant Psychologist; School of Psychology, University of New South Wales, Sydney, New South Wales, Australia; and Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
Abstract
Purpose This review aims to provide a broad overview of the issues and clinical challenges of nonadherence in adolescents and young adults (AYAs) with cancer. Nonadherence can reduce treatment efficacy, which places the patient at higher risk of relapse, adverse effects, and poor outcomes. Design A review of the English-speaking literature between 1980 and 2008 was conducted to identify relevant publications, which were supplemented by reference and author searches. Results Definition and measurement of adherence varies. Most studies have not clearly delineated an AYA age group (ie, 15-25 years) and have been dominated by leukemia and lymphoma samples. Estimates for nonadherence in this population range from 27% to 60%, with openness of family relationships and support found to predict adherence. Strategies to avoid, assess, and manage nonadherence are presented. Conclusion Overall, the evidence base for adherence and strategies to promote it in AYAs with cancer is woefully lacking. There is a need for high-quality studies that target clinically important questions, randomized controlled trials of theoretically based interventions, and development and evaluation of training programs for oncology staff in the special issues faced by AYAs with cancer.
Publisher
American Society of Clinical Oncology (ASCO)
Cited by
213 articles.
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