Adult; cancer; medication adherence; medication compliance; neoplasm; oral chemotherapy; patient compliance; patient education; therapeutic education.
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国家:United States
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BACKGROUND: Adherence to oral cancer medicines is a challenge for adult patients with cancer. Education specifically tailored for an individual patient with cancer may improve adherence. Therapeutic patient education when utilized effectively may maximize health outcomes and positively affect the quality of life of adult patients with cancer. Currently, there are no published systematic reviews specific to the effectiveness of therapeutic patient education on improvement of oral anti-cancer medicines adherence in patients with cancer. OBJECTIVES: To synthesize the best available evidence on the effectiveness of therapeutic patient education on adherence to oral anti-cancer medicines in adult cancer patients 18 years and older in an ambulatory care setting. INCLUSION CRITERIA: Types of participants: This review considered studies involving adults of any ethnicity, race or gender, aged 18 years or older who were diagnosed with any form of cancer, receiving oral anti-cancer medicines in an ambulatory care setting. Types of intervention(s): This review considered studies on the use of therapeutic patient education as the additional intervention to routine patient education for promoting oral anti-cancer medicine adherence in adult patients with cancer in an ambulatory care setting. Routine patient education was considered as a comparator. Types of outcomes: The outcome considered was adherence to prescribed oral anti-cancer medicines. Types of studies: This review considered experimental and observational studies. SEARCH STRATEGY: The literature search included published and unpublished studies in the English Language from 1953 through August 2014. A search of PubMed, CINAHL, Excerpta Medica Database, Academic Search Premier, Cochrane Library, PsycINFO, and Health Source: Nursing/Academic Edition was conducted using identified keywords and indexed terms across all included databases. A search for grey literature and electronic hand searching of relevant journals was also performed. METHODOLOGICAL QUALITY: Two reviewers independently evaluated the included studies for methodological quality utilizing standardized critical appraisal instruments from the Joanna Briggs Institute. DATA COLLECTION: Standardized data extraction tools were used by two reviewers independently as per the Joanna Briggs Institute for data extraction. DATA SYNTHESIS: Due to clinical and methodological heterogeneity between the included studies, statistical meta-analysis was not feasible. The results are presented in a narrative form. RESULTS: Two studies were included in this review, one randomized controlled trial and one cohort study. Both studies had small sample sizes and were moderate and low quality. The clinical significance of therapeutic patient education interventions and the relationship between behavior changes and health outcome changes remain unclear. The randomized clinical trial found a benefit in medication adherence rates in the tailored education intervention group compared to the standard education group at two and four months. Adherence rates measured by self-report (91.3% and 95.1%) and pharmacy refill rates (80% and 73.7%) were superior for the intervention group; however pharmacy refill rates were lower than self-reports of adherence. Tailored educational interventions were only beneficial on pharmacy refill rates (p=.0048) for promoting adherence at the two-month time interval. The cohort study found the intensified pharmaceutical educational intervention group demonstrated enhanced overall medication adherence then the standard education group TRUNCATED AT 500 WORDS
Adult; cancer; medication adherence; medication compliance; neoplasm; oral chemotherapy; patient compliance; patient education; therapeutic education.
医疗护理 ; 口腔卫生
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