The Association among Adherence, Self-Efficacy, and Health-Related Quality of Life In Cancer Patients with Oral Chemotherapy in Indonesia
Main Article Content
Keywords
Adherence, Self Efficacy, Health related quality of life, oral chemotherapy, cancer
Abstract
Background: Cancer patients undergoing oral chemotherapy are prone to suffer from low medication compliance and poor quality of life. The psychosocial factor of self-efficacy influences medication adherence. However, there is a lack of studies on the relationship between the three in cancer patients taking oral chemotherapy. Objective: This study aimed to explore medication adherence, self-efficacy, and health-related quality of life (HRQOL), examine the relationship among these variables, and determine the predictor of medication adherence. Methods: This cross-sectional study was conducted at a national cancer center in Indonesia from July 2021 to February 2022. Cancer outpatients aged 18 years or older taking oral chemotherapy capecitabine were included. Patients’ socio-demographics, disease, and therapy characteristics were collected from medical records and questionnaires. Adherence, self-efficacy, and HRQOL were measured using self-reported questionnaires. Results: The study included 118 patients. The mean adherence score was 92.11% (SD=6.87%), and 79.67% of patients were adherent. The self-efficacy for appropriate medication use score ranged from 61.54 to 100%, with a mean score of 90.39%. The mean global score for HRQOL was 70.13 (SD=19.01). There was a significant positive correlation between medication adherence and self-efficacy (r=0.410, p< 0.001), self-efficacy and physical, role, and cognitive functional (r=0.185, p<0.05; r=0.197, p< 0.05, r=0.221, p<0.05, respectively). Medication adherence was negatively correlated with global quality of life (r=-0.199, p<0.05). This study did not find a correlation between self-efficacy and global quality of life. Multivariate analysis showed that the significant predictors of medication adherence were higher education, shorter duration of treatment, and higher self-efficacy. Conclusions: These findings provide valuable insights into patterns and correlations of oral chemotherapy adherence, self-efficacy, and HRQOL in cancer patients. Developing a future program is essential to enhancing cancer patients receiving oral chemotherapy’s medication compliance, self-efficacy, and quality of life.
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medication adherence and persistence to oral anticancer drugs: A systematic review. Cancer Treat Rev. 2013;39(6):610-21. http://dx.doi.org/10.1016/j.ctrv.2012.12.014
2. Schneider SM, Hess K, Gosselin T. Interventions to Promote Adherence with Oral Agents. Semin Oncol Nurs. 2011;27(2):133-41. http://dx.doi.org/10.1016/j.soncn.2011.02.005
3. Li M, Chen J, Deng Y, Yan T, Gu H, Zhou Y, et al. Risk prediction models based on hematological/body parameters for
chemotherapy-induced adverse effects in Chinese colorectal cancer patients. Support Care Cancer. 2021;29(12):7931-47.
https://doi.org/10.1007/s00520-021-06337-z
4. Bhattacharyya GS. Oral systemic therapy: Not all “win-win.” Indian J Med Paediatr Oncol. 2010;31(1):1-3. https://doi.org/10.4103/0971-5851.68844
5. Menditto E, Guerriero F, Orlando V, Crola C, Di Somma C, Illario M, et al. Self-assessment of adherence to medication: A case study in campania region community-dwelling population. J Aging Res. 2015;2015:682503. https://doi.org/10.1155/2015/682503
6. Puts MTE, Tu HA, Tourangeau A, Howell D, Fitch M, Springall E, et al. Factors influencing adherence to cancer treatment in older adults with cancer: A systematic review. Ann Oncol. 2014;25(3):564-77. https://doi.org/10.1093/annonc/mdt433
7. Ruddy K, Mayer E, Partridge A. Patient adherence and persistence with oral anticancer treatment. CA Cancer J Clin. 2009;59(1):56-66. https://doi.org/10.3322/caac.20004
8. Lam WY, Fresco P. Medication Adherence Measures: An Overview. Biomed Res Int. 2015:2015:217047. https://doi.org/10.1155/2015/217047
9. Leslie R Martin, Summer L Williams, Kelly B Haskard MRD. The Challenge of Patient Adherence. Ther Clin Risk Manag.
2005;1(3):189-99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661624/
10. Mislang AR, Wildes TM, Kanesvaran R, Baldini C, Holmes HM, Nightingale G, et al. Adherence to oral cancer therapy in older adults: The International Society of Geriatric Oncology (SIOG) taskforce recommendations. Cancer Treat Rev. 2017;57:58-66. http://dx.doi.org/10.1016/j.ctrv.2017.05.002
11. World Health Organization. Adherence to long-term therapies: Evidence for action. Geneva: World Health Organization; 2003;2(4):323. https://doi.org/10.1016/s1474-5151(03)00091-4
12. Kimmick G, Edmond SN, Bosworth HB, Peppercorn J, Marcom PK, Blackwell K, et al. Medication taking behaviors among breast cancer patients on adjuvant endocrine therapy. The Breast. 2015;24(5):630-6. http://dx.doi.org/10.1016/j.breast.2015.06.010
13. Bandura A. Self-Efficacy. In: Encyclopedia of mental health. 1998;1-65.
14. Risser J, Jacobson TA, Kripalani S. Development and Psychometric Evaluation of the Self-Efficacy for. J Nurs Meas.
2007;15(3):203-19.
15. Colombo LRP, Aguiar PM, Lima TM, Storpirtis S. The effects of pharmacist interventions on adult outpatients with cancer: A systematic review. J Clin Pharm Ther. 2017;42(4):414-24. https://doi.org/10.1111/jcpt.12562
16. Kaplan W. Background Paper 6.5 Cancer and Cancer Therapeutics. 2013;1-62. https://www.who.int/medicines/areas/priority_medicines/BP6_5cancer.pdf
17. Bhattacharya D, Easthall C, Willoughby KA, Small M, Watson S. Capecitabine non-adherence: Exploration of magnitude, nature and contributing factors. J Oncol Pharm Pract. 2012;18(3):333-42. https://doi.org/10.1177/1078155211436022
18. Lavsa SM, Holzworth A, Ansani NT. Adherence. J Am Pharm Assoc. 2011;51:90-4.
19. Gozum S, Hacihasanoglu R. Reliability and validity of the Turkish adaptation of medication adherence self-efficacy scale in hypertensive patients. Eur J Cardiovasc Nurs. 2009;8(2):129-36. http://dx.doi.org/10.1016/j.ejcnurse.2008.10.006
20. Cameron KA, Ross EL, Clayman ML, Bergeron AR, Federman AD, Cooper S, et al. Patient Education and Counseling
Measuring patients ’ self-efficacy in understanding and using prescription medication. Patient Educ Couns. 2010;80(3):372-6. http://dx.doi.org/10.1016/j.pec.2010.06.029
21. Daniali S, Darani F, Eslami A, Mazaheri M. Relationship between Self-efficacy and Physical Activity, Medication Adherence in Chronic Disease Patients. Advanced Biomedical Research. 2017;6:63. https://doi.org/10.4103/2277-9175.190997
22. Ebrahimi A, Ahmadi M, Mahmoudi S. The Impact of Self-efficacy and Health Literacy on Medication Adherence and Healthrelated Quality of Life in Patients with Heart Failure: A Systematic Review. J Clin Res Paramed Sci. 2022;11(2).
23. Wu XY, Zhuang LH, Li W, Guo HW, Zhang JH, Zhao YK, et al. The influence of diet quality and dietary behavior on healthrelated quality of life in the general population of children and adolescents: a systematic review and meta-analysis. Qual Life Res. 2019;28(8):1989-2015. https://doi.org/10.1007/s11136-019-02162-4
24. Bagcivan G, Akbayrak N. Development and Psychometric Testing of the Turkish-Version Oral Chemotherapy Adherence Scale. J Nurs Res. 2015;23(4):243-51. https://doi.org/10.1097/jnr.0000000000000101
25. Perwitasari DA, Atthobari J, Dwiprahasto I, Hakimi M, Gelderblom H, Putter H, et al. Translation and validation of EORTC QLQ-C30 into Indonesian version for cancer patients in Indonesia. Jpn J Clin Oncol. 2011;41(4):519-29. https://doi.org/10.1093/jjco/hyq243
26. Ross XS, Gunn KM, Suppiah V, Patterson P, Olver I. A review of factors influencing non-adherence to oral antineoplastic drugs. Support Care Cancer. 2020;28:4043-50. https://doi.org/10.1007/s00520-020-05469-y
27. Winterhalder R, Hoesli P, Delmore G, Pederiva S, Bressoud A, Hermann F, et al. Self-reported compliance with capecitabine: Findings from a prospective cohort analysis. Oncology. 2011;80(1-2):29-33. https://doi.org/10.1159/000328317
28. Zahrina AK, Norsa’adah B, Hassan NB, Norazwany Y, Norhayati MI, Roslan MH, et al. Adherence to capecitabine treatment and contributing factors among cancer patients in Malaysia. Asian Pacific J Cancer Prev. 2014;15(21):9225-32. https://doi.org/10.7314/apjcp.2014.15.21.9225
29. Partridge AH, Archer L, Kornblith AB, Gralow J, Grenier D, Perez E, et al. Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: Adherence companion study 60104. J Clin Oncol. 2010;28(14):2418-22. https://doi.org/10.1200/jco.2009.26.4671
30. Krolop L, Ko Y-D, Schwindt PF, Schumacher C, Fimmers R, Jaehde U. Adherence management for patients with cancer
taking capecitabine: A prospective two-arm cohort study. BMJ Open. 2013;3(7):e003139. https://doi.org/10.1136/bmjopen-2013-003139
31. Simons S, Ringsdorf S, Braun M, Mey UJ, Schwindt PF, Ko YD, et al. Enhancing adherence to capecitabine chemotherapy by
means of multidisciplinary pharmaceutical care. Support Care Cancer. 2011;19(7):1009-18. https://doi.org/10.1007/s00520-010-0927-5
32. Hefner J, Berberich S, Lanvers E, Sanning M, Steimer AK, Kunzmann V. Patient-doctor relationship and adherence to
capecitabine in outpatients of a german comprehensive cancer center. Patient Prefer Adherence. 2018;12:1875-87. https://doi.org/10.2147/ppa.s169354
33. Muluneh B, Schneider M, Faso A, Amerine L, Daniels R, Crisp B, et al. Improved Adherence Rates and Clinical Outcomes
of an Integrated , Closed-Loop , Pharmacist-Led Oral Chemotherapy Management Program. Am Soc Clin Oncol. 2019;14(6):e324-e334. https://doi.org/10.1200/jop.17.00039
34. Liu J, Liu Z, Ding H, Yang X. Adherence to treatment and influencing factors in a sample of Chinese epilepsy patients. Epileptic Disord. 2013;15(3):289-94. https://doi.org/10.1684/epd.2013.0588
35. Boeni F, Spinatsch E, Suter K, Hersberger KE, Arnet I. Effect of drug reminder packaging on medication adherence: A systematic review revealing research gaps. Syst Rev. 2014;3(1):29. https://doi.org/10.1186/2046-4053-3-29
36. Kawakami K, Nakamoto E, Yokokawa T, Sugita K, Mae Y, Hagino A, et al. Patients’ self-reported adherence to capecitabine on XELOX treatment in metastatic colorectal cancer: Findings from a retrospective cohort analysis. Patient Prefer Adherence.2017;9:561-7.
37. Wood L. A review on adherence management in patients on oral cancer therapies. Eur J Oncol Nurs. 2012;16(4):432-8. https://doi.org/10.1016/j.ejon.2011.10.002
38. Vacher L, Thivat E, Poirier C, Mouret-Reynier MA, Chollet P, Devaud H, et al. Improvement in adherence to Capecitabine
and Lapatinib by way of a therapeutic education program. Support Care Cancer. 2020;28(7):3313-22. https://doi.org/10.1007/s00520-019-05144-x
39. Jiang Y, Wickersham KE, Zhang X, Barton DL, Farris KB, Krauss JC, et al. Side effects, self-management activities, and
adherence to oral anticancer agents. Patient Prefer Adherence. 2019;13:2243-52. https://doi.org/10.2147/ppa.s224496
40. Náfrádi L, Nakamoto K, Schulz PJ. Is patient empowerment the key to promote adherence? A systematic review of the
relationship between self-efficacy, health locus of control and medication adherence. PLoS One. 2017;12(10):1-23. https://doi.org/10.1371/journal.pone.0186458
41. Ritter PL, Lorig K. The English and Spanish Self-Efficacy to Manage Chronic Disease Scale measures were validated using multiple studies. J Clin Epidemiol. 2014;67(11):1265-73 http://dx.doi.org/10.1016/j.jclinepi.2014.06.009
42. Mystakidou K, Parpa E, Tsilika E. General perceived self-efficacy : validation analysis in Greek cancer patients. Support Care Cancer. 2008;16:1317-22. https://doi.org/10.1007/s00520-008-0443-z
43. Huang F, Yang Q, Wang A, Zhang J. Psychometric properties and performance of existing self-efficacy instruments in cancer populations : a systematic review. Health Qual Life Outcomes. 2018;9(16):1-12. https://doi.org/10.1186/s12955-018-1066-9
44. Rosli NA, Mazapuspavina MY, Ismail Z, Ismail NE. Relationship of Self Efficacy in Medication Understanding with Quality of Life among Elderly with Type 2 Diabetes Mellitus on Polypharmacy in Malaysia. Int J Environ Res Public Health. 2022;19(5):3031. https://doi.org/10.3390/ijerph19053031
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Feb 28, 2025
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The Association among Adherence, Self-Efficacy, and Health-Related Quality of Life In Cancer Patients with Oral Chemotherapy in Indonesia. Pharm Pract (Granada) [Internet]. 2025 Feb. 28 [cited 2025 Apr. 21];23(1):1-8. Available from: https://pharmacypractice.org/index.php/pp/article/view/3107
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How to Cite
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The Association among Adherence, Self-Efficacy, and Health-Related Quality of Life In Cancer Patients with Oral Chemotherapy in Indonesia. Pharm Pract (Granada) [Internet]. 2025 Feb. 28 [cited 2025 Apr. 21];23(1):1-8. Available from: https://pharmacypractice.org/index.php/pp/article/view/3107