medication compliance among breast cancer patients on long-term adjuvant chemotherapy
abstract
treatment compliance refers to performing behaviours which follow a
course of treatment that has been agreed upon by the patient and the
health care professional. noncompliance can result in prolongatiorr of
current health problems, may lead to more extensive treatments, may
compromise the effectiveness of treatment and may increase the chance
of recurrence. the present pilot study, carried out at the thunder bay
regional cancer centre, assessed the compliance of 20 female breast
cancer patients taking tamoxifen, an oral medication considered to have
prophylactic benefits. measures were taken on desirability of control
(burger & cooper, 1979), health locus of control (wallston, wallston &
devellis, 1978), mood states (the profile of mood states, celia et al.,
1987), quality of life (functional living index - cancer, schipper et al.,
1984), and the patients' perceptions of the cancer centre, their
relationship with their oncologist, and their own likely rate of compliance.
further, half of the subjects were asked to complete a daily diary of their
medication taking. each patients' physician was asked to provide
information on diagnosis, present status, physical functioning rating and
likely compliance rate. subjects were seen four times over a six-week
period. at these meetings, the investigator counted the number of pills
(tamoxifen) remaining in the bottje and asked the subject to complete
the quality of life measure. subjects were not told this was a study of
compliance.
it was hypothesized that:
1. patients scoring lower on the quality of life measure would be more
likely to be compliant than those whose quality of life was high.
2. patients who displayed an internal locus of control, who scored high
on desirability of control, and whose relationship with their oncologist allowed for this internal/high desire control would be more compliant
than similar patients whose relationship did not allow for this control.
3. patients showing signs of mood disturbance would be less compliant
to the medication regimen.
4. patients regarding the centre highly would be more compliant.
5. patients on the regimen for a longer period of time would be less
compliant than those just beginning the regimen.
6. patients' predictions about their own rate of compliance would
accurately reflect actual compliance, while oncologists' predictions would
not be accurate and would overestimate actual compliance rates.
7. patients who kept a daily medication diary would be more compliant
than those not using a diary.
the hypotheses were not supported by the data with the exception that
oncologists' predictions of compliance were not related to actual
compliance. however, age was significantly related to compliance in that
older women were more likely to be compliant to the medication
regimen. also, it appears that oncologists base their estimations of
compliance on the length of time which has elapsed since the patient first
began treatment - a factor showing no relationship to actual compliance
rate. several tentative, albeit statistically nonsignificant, relationships
provide compelling suggestions for future research. also, implications for
the care of cancer patients are discussed.
collections
- retrospective theses [1604]