Cognitive disorders can affect adherence to oral cancer therapies, a European conference has heard.
Both memory dysfunction and depression are linked to non-adherence, the conference of the European Society of Medical Oncology heard.
Researchers Professor Florence Joly and Dr Melanie Dos Santos, of the Centre Francois Baclesse, Caen, France, say that cognitive disorders may be under-estimated as a cause of non-adherence.
They studied some 126 patients, of whom half were over the age of 70. There was an adherence rate of 90%.
Professor Joly said: “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.
“This study included patients starting a new oral therapy and half were over 70 years of age. Before starting treatment, a standardised neuropsychological test battery including an assessment of autonomy, depression and anxiety were performed. Information on socio-demographic conditions was also collected. Adherence to oral therapy was evaluated by self-assessment questionnaires and an observance sheet.”
Dr Bettina Ryll, who chairs a patient advocacy working group for ESMO, said doctors need to understand the factors that may lead to patient non-adherence.
She said: “I believe the current concept of adherence is too narrow i.e. physicians expect patients to take their medication as prescribed and non-adherence is considered a form of disobedience.
"Intentional non-adherence, the patient deciding not to take medication as indicated, is actually revealing patients’ true preferences and these might simply be very different from what physicians and other stakeholders consider relevant.
"So instead of enforcing adherence against patients’ preferences, we need to first understand and then tackle the true reasons underlying non-adherence.”
Abstract 1497P – Impact of cognitive functions on oral anticancer therapies adherence M. Dos Santos, M. Lange, B. Clarisse, M. Barillet, F. Joly; Caen, FR
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