Facilitators and barriers to adherence to medical recommendations among adolescents with cancer: A systematic review.
Ágata Salvador, Shivani Atul Mansuklal, Maria Moura and 2 others
PMID 37864440WHAT IT FOUND
Adolescents with cancer were less likely to follow medical recommendations when they felt treatment threatened normalcy, had depression or poor family support, faced side effects, forgetfulness, costs, or transport problems.
Key findings
01Adolescents with worse quality of life, higher trait anxiety, or depressive symptoms were less likely to adhere.
02Parental emotional support, supervision, and encouragement promoted medication adherence, while family financial stress and transport or routine difficulties hindered it.
03Treatment side effects such as fatigue, nausea, and pain, more complex regimens, and the transition from intensive to maintenance treatment were associated with poorer adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only peer-reviewed English studies were searched, so relevant non-English or unpublished work may have been missed. The included studies had small and varied samples, and most were single-institution, cross-sectional studies. Adherence was defined and measured differently across studies, including medication only, broader health behaviours, self-report, parent report, physician report, interviews, drug assay, electronic monitoring, and medical files. Risk of bias was not used to exclude studies because there was little research in the field. Most quantitative studies did not adjust for other factors that could explain the results, so the reported associations may not be independent effects. Few qualitative studies discussed data saturation or the relationship between researcher and participants. Most included studies were cross-sectional, so the review cannot establish direction of effects.
Declared interests
The authors declared no potential conflicts of interest. Funding came from the Foundation for Science and Technology, Portuguese Ministry of Science, Technology and Higher Education, grant UIDB/05380/2020, and Lusophone Institute for Research and Development, ILIND/F+/EI/03/2020.
The easy way to misread this
Do not read these factors as proven causes or as a tested intervention. Most included studies were cross-sectional, and the review did not show that changing any factor improves adherence.