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A B S T R A C T S
S115
P132
BARRIERS TO GOOD MEDICATION TAKING BEHAVIOUR IN
METASTATIC PROSTATE CANCER PATIENTS RECEIVING
ORAL ANTI-ANDROGEN THERAPY
S. Ahrari
1,2,
*, K. Farr
1
, L. Buddo
1,3
, A. Thawer
1
, A. Giotis
1
,
M. Puts
4
, C. De Angelis
1,2
1
Pharmacy, Sunnybrook Odette Cancer Centre,
2
Leslie Dan Faculty
of Pharmacy, University of Toronto, Toronto,
3
Pharmacy, University
of Waterloo, Waterloo,
4
Lawrence S Bloomberg Faculty of Nursing,
University of Toronto, Toronto, Canada
Introduction:
Oral anti-cancer medication adherence is of
increasing concern.The metastatic castrate resistant prostate
cancer population (mCRPC) is generally older, with multiple
co-morbidities and medications. These increase barriers to
medication adherence.
Objectives:
To better understand adherence barriers
adherence in mCRPC and identify counseling strategies that
mitigate them.
Methods:
This prospective, exploratory mixed-methods
study included men with mCRPC starting abiraterone or
enzalutamide. After medication counseling, participants
completed validated questionnaires and medication lists,
then were interviewed at 24 hours and 1 month about their
medications.
Questionnaires and demographics was summarized
using descriptive statistics.Semi-structured interviews were
analyzed for underlying themes of effective counseling.
Results:
We evaluated 12 patient responses. Most under-
stood their medications and had good health literacy and
cognitive function. Median age was 77, with three co-
morbidities, seven chronic medications, and strong caregiver
support at home. In addition, most patients had positive
beliefs about medications and good baseline adherence.
Despite positive characteristics, there was an identified gap in
medication counseling efficacy.
First, participants stressed the benefit of having drug
information repeated by multiple providers. In addition,
good medication adherence was associated with tailored
counselling, wherein providers discussed good medication
taking behaviours in the context of individual daily life.
Second, most participants recalled general side effects
and safe handling instructions, but did not recall specific
side effects or management strategies. This is an important
consideration when assessing medication understanding.
Finally, participants had mixed responses regarding drug
information sheets. Usage varied, although participants
appreciated pharmacists highlighting important points as it
provided visual cues that guided drug education sessions.
Conclusion:
In order to maximize the benefit of medication
counseling, health providers should mark information sheets
with important points to tailor education. Tailoring improves
information recall and improves medication adherence.
In addition, breaking counseling sessions into topic-based
chunks improves the flow of counseling and provides time for
patients to absorb information, thus improving confidence.
Regardless of how confident providers are in a patient’s ability
to understand their treatment, there are clear barriers that
need to be overcome in order to ensure safe and efficacious
use of oral anti-cancer agents.
References:
[1] Canadian
Cancer
Society.Toronto.Prostate
cancer
statistics;2014.
[2] D’amato S. Improving Patient Adherence with Oral
Chemotherapy. Oncology Issues. Jul/Aug 2008, 42-5.
[3] Gebbia V et al.Adherence, compliance and persistence
to oral antineoplastic therapy. Expert Opin Drug Saf.
2012;11(S1):S49-59.
[4] Sandelowski M. Sample size in qualitative research. Res
Nurs Health. 1995 April; 18(2):179-183.
[5] Mathes, T et al. Adherence enhancing interventions for
oral anti-cancer agents: A systematic review. Cancer Treat
Rev.2013;40(1):102-8.
[6] Ritchie J, Lewis J. Qualitative Research Practice: A Guide
for Social Science Students and Researchers. London,
UK: SAGE Publications; 2003. Chapter 4, Designing and
Selecting Samples. p.77-108.
[7] Thorne S et al. Interpretive Description: A Noncategorical
Qualitative Alternative for Developing Nursing Knowledge.
Res Nurs Health.1997;20(2):169-77.
Disclosure of interest:
S. Ahrari: None declared, K. Farr:
None declared, L. Buddo: None declared, A. Thawer: None
declared, A. Giotis: None declared, M. Puts: None declared, C.
De Angelis Grant/Research Support from: Astellas Canada
Keywords:
Anti-androgen therapy, medication adherence,
oral anti-cancer medication, patient counseling, prostate,
bladder, kidney, genitourinary cancers
P133
THE DEVELOPMENT OF DISTRESS IN OLDER PATIENTS
WITH CANCER IN THE MID-LONG TERM
S. Dauphin
1,
*, T. De Burghgraeve
1
, F. Buntinx
1,2
,
M. van den Akker
1,2
1
Department of General Practice, KU Leuven, Leuven, Belgium,
2
Department of Family Medicine, Maastricht University, Maastricht,
Netherlands
Introduction:
Older patients with cancer suffer from a
variety of psychosocial problems and distress is one of them.
However, we know little about the evolution of distress over
time (up to three years after diagnosis) and the influence of
baseline characteristics on levels of distress.
Objectives:
To describe the evolution of distress over time
(up to three years after diagnosis) and examine the influence
of baseline characteristics on levels of distress.
Methods:
The KLIMOP study is an ongoing prospective
Flemish - Dutch cohort study. The cohort consists of older
patients with cancer (
70 years) and 2 control groups: middle-
aged patients with cancer (50-69 years) and older people
without cancer (
70 years).Through the use of a questionnaire
we gathered data from the validated Distress Barometer. Data
was collected shortly after diagnosis (baseline, N = 1496)
and three years (preliminary data) after baseline. The data is
analyzed with SPSS 23 using logistic regression.