A Mixed Method to Study Adherence to Oral Anticancer Medications in a Multilingual and Multicultural Setting

Patients with haematologic malignancies are increasingly treated by Oral Anticancer Medications (OAMs), increasing the challenge of ensuring optimal adherence to treatment. However, except for Chronic Myelogenous Leukemia (CML) or Acute Lymphoid Leukemia (ALL), the extent of non-adherence has rarely been investigated in an outpatient setting. In Belgium, the only available data suffers from critical underrepresentation of patients from minority diverse population. In the context of increasing migration, the identification of differences in access and drug use that may lead to health disparities is crucial. Based on a sequential mixed method study design, our objectives are to measure adherence to OAMs in two subgroups of non-migrants and migrants with various haematological malignancies, to identify the associated risk factors and to explore the representations that come into play with regards to illness and adherence behaviors. Essentially, the MADESIO protocol will contribute to assess whether and why patients with migrant backgrounds are a risk group regarding adherence to OAMs.

Sex

All

Minimum age

18 Years

INCLUSION CRITERIA:

* Adult (≥ 18)
* Any diagnosis of haematological malignancy
* Treatment by minimum one OAM
* Treatment since minimum 30 days
* At least 6 months of life expectancy.
* Being able to speak and read French, Dutch, English, Polish, Romanian, or Arabic.

EXCLUSION CRITERIA:

* Illiterate patient.
* Uncontrolled acute psychiatric disease

• BACKGROUND1) Noens et al. (2009). Prevalence, determinants, and outcomes of nonadherence to imatinib therapy in patients with chronic myeloid leukemia: the ADAGIO study. Blood. 113(22), 5401-11. 2) Bhatia et al. (2012). Nonadherence to Oral Mercaptopurine and Risk of Relapse in Hispanic and Non-Hispanic White Children With Acute Lymphoblastic Leukemia: A Children's Oncology Group study. J. Clin. Oncol. 30(17), 2094-101. 3) Ruddy et al. (2009) Patient adherence and persistence with oral anticancer treatment. CA: A Cancer Journal for Clinicians, 59(1):56-66 4) Greer et al. A systematic review of adherence to oral antineoplastic therapies. Oncologist 2016; 21:354-376 5) Hall et al.(2016) To adhere or not to adhere: Rates and reasons of medication adherence in haematological cancer patients, Critical Reviews in Oncology/Hematology. 97:247-262 6) Lepièce (2016). Discrimination dans la consultation médicale interethnique de médecine générale ? (PhD. Thesis), UCL. 7) Van Keer et al. (2015). Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: an ethnographic. Critical Care. 19 (441). 8) Van Wieringen et al. (2002). Intercultural communication in general practice. European Journal of Public Health. 12, 63-68 9) Sleath et al. (2003) Hispanic ethnicity physician-patient communication, and antidepressant adherence. Compr Psychiat. 44:198-204. 10) Cooper et al. (2003) Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med, 139:907-15. 11) Nieuwkerk PT, et al. Self-reported adherence is more predictive of virological treatment response among patients with a lower tendency towards socially desirable responding. Antivir Ther. 2010;15:913-916. 12) Stöbber (2001) The Social Desirability Scale-17 (SDS-17) European Journal of Psychological Assessment, 17, pp. 222-232 13) George et al. (2005) Development and validation of the Beliefs and Behaviour Questionnaire (BBQ). Patient Education and Counseling.64(1-3): 50-60 14) Garfield et al. Suitability of measures of self-reported medication adherence for routine clinical use: a systematic review. BMC Med Res Methodol. 2011; 11:149. 15) Morisky, D. E., et al. (2008). Predictive Validity of A Medication Adherence Measure in an Outpatient Setting. Journal of Clinical Hypertension (Greenwich, Conn.), 10(5), 348-354. 16) George et al. (2005) Development and validation of the Beliefs and Behaviour Questionnaire (BBQ). Patient Education and Counseling.64(1-3): 50-60 17) Wang et al. Psychometric properties of the 8-item Morisky Medication Adherence Scale in patients taking warfarin. Thromb Haemost 2012; 108: 1-7. 18) Reynolds et al. Psychometric properties of the Osteoporosis-specific Morisky Medication Adherence Scalein postmenopausal women with osteoporosis newly treated with bisphosphonates. Ann Pharmacother 2012; 46: 659-70. 19) Horne, R., et al. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health 2002; 17: 17-32. 20) Horne et al. (1999). Beliefs about medicines questionnaire (BMQ). Psychology and Health. 14:1-24. 21) Mack et al. (2009) Measuring therapeutic alliance between oncologists and patients with advanced cancer: The human Connection Scale. Cancer. 115 (14):3302-3311 22) Jing et al. Factors affecting therapeutic compliance: A review from the patient's perspective Ther Clin Risk Manag. 2008 Feb; 4(1): 269-286 23) Snaith (2003) The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes. 1:29. doi:10.1186/1477-7525-1-29 24) Zerbe et al. (1987). Socially desirable responding in organizational behaviour: A reconception.Academy of Management Review, 12, 250-264 25) Cha et al., Translation of scales in cross-cultural research: issues and techniques. Jan Research Methodology, 10.jan 2017, pg.386-395 26) bombardier, F. et al. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993 Dec; 46(12):1417-32. 27) Groleau et al. (2006). The McGill Illness Narrative Intervew (MINI): an interview schedule to elicit meanings and modes of reasoning related to illness experience. Transcultural Psychiatry, 43(4):671-691. 28) Weiner (1985). 'Sponteneous' causal thinking. Psychology Bulletin, 97, 74-84 29) Krousel-Wood et al. New medication adherence scale versus pharmacy fill rates in seniors with hypertension.Am J Manag Care 2009; 15: 59-66. 30) Ross et al. Patient compliance in hypertension: role of illness perceptions and treatment beliefs. J Hum Hypertens 2004; 18: 607-13 31) Berglund et al. Adherence to and beliefs in lipid-lowering medical treatments: a structural equation modeling approach including the necessity-concern framework. Patient Educ Couns 2013; 91: 105-12. 32) etc.