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Salvador Á, Mansuklal SA, Moura M, Crespo C, Barros L. Facilitators and barriers to adherence to medical recommendations among adolescents with cancer: A systematic review. J Child Health Care 2023:13674935231208502. [PMID: 37864440 DOI: 10.1177/13674935231208502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
We aimed to systematically review barriers/facilitators of adherence among adolescents with cancer (aged 10-24 years), following a comprehensive approach to adherence that goes beyond medication-taking. Empirical studies published in English exploring determinants of adherence to medical recommendations among adolescents with cancer were identified in MEDLINE, PsycInfo, and Web of Science, up to October 2021. Records and full-text articles were reviewed by two independent reviewers, and results were classified according to the World Health Organization's (WHO) multidimensional adherence model. Eighteen studies were included. Despite heterogeneity in the definition and measurement of adherence, literature supported barriers/facilitators at patient, treatment, condition, healthcare team/system, and social/economic levels. Specifically, patient-related factors (i.e., psychological functioning and beliefs about disease and treatment) and social-related factors (i.e., family functioning) were major determinants of adolescent adherence. Few studies were conducted, and inconsistent findings were displayed for other dimensions (i.e., healthcare team/system, treatment, and condition-related factors). Adherence is a complex and multidetermined phenomenon. More research is needed to provide critical insights for policymakers and healthcare professionals in planning practices and interventions that effectively address meaningful barriers/facilitators of adolescents' adherence.
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Affiliation(s)
- Ágata Salvador
- HEI-Lab, Lusófona University, Lisbon, Portugal
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | | | - Maria Moura
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
- Instituto Português de Oncologia de Lisboa Francisco Gentil EPE, Lisbon, Portugal
| | - Carla Crespo
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
| | - Luísa Barros
- Research Center for Psychological Science, Faculty of Psychology, University of Lisbon, Lisbon, Portugal
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Efficacy of a culturally tailored cognitive-behavioural intervention for Ethiopian children with haematological malignancies: study protocol for randomised controlled trial. Trials 2022; 23:811. [PMID: 36163030 PMCID: PMC9513975 DOI: 10.1186/s13063-022-06768-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background Paediatric cancer patients often experience anxiety and depression. Evidence suggests that cognitive-behavioural interventions may help reduce anxiety and depression in children undergoing cancer treatment. However, only a few studies evaluated its impact on the psychological well-being and quality of life of paediatric cancer patients globally. In Ethiopia, there has been no published study to date. Thus, this trial aims to evaluate the efficacy of a culturally tailored cognitive-behavioural intervention for Ethiopian children with haematological malignancies receiving chemotherapy. Methods A single-blinded, parallel-group, two-arm, repeated measure randomised controlled trial will be conducted. Eighty children aged 8 − 18 years with haematological malignancy receiving chemotherapy will be recruited and randomly assigned to experimental or control groups. The experimental group will receive five sessions of introducing cognitive-behavioural intervention, identifying and modifying maladaptive thoughts and behaviour, behavioural activation, practising deep breathing exercises, reassessing goals or treatment plans, and encouraging participants to maintain changes. Each session will be conducted face-to-face for 30–35 min a week. The control group will receive usual care. The outcomes will be measured at baseline, post-intervention, and one month after the intervention using the Revised Child Anxiety and Depression Scale and Paediatric Quality of Life Inventory Generic Core Score 4.0. Discussion The findings of this study will provide evidence to support the integration of culturally effective cognitive-behavioural intervention strategies into paediatric oncology practice and thus, add new knowledge to the literature and help improve the care of children with haematological malignancies receiving chemotherapy. If the cognitive-behavioural intervention is shown to be effective and culturally acceptable, it will provide evidence to include the intervention as a standard of care in paediatric haematology/oncology. Trial registration ClinicalTrials.gov NCT05270655. Registered on March 8, 2022. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06768-x.
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Vandermorris A, Sampson L, Korenblum C. Promoting adherence in adolescents and young adults with cancer to optimize outcomes: A developmentally oriented narrative review. Pediatr Blood Cancer 2020; 67:e28128. [PMID: 31886630 DOI: 10.1002/pbc.28128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/10/2019] [Accepted: 11/25/2019] [Indexed: 01/03/2023]
Abstract
Adherence is a critical consideration in ongoing efforts to improve outcomes among adolescents and young adults (AYAs) with cancer. In this narrative review, we embed existing conceptualizations of adherence within a developmental context to provide a novel vantage point from which to examine this important issue. Applying this developmentally oriented framework, we summarize the most current literature on strategies to enhance adherence in the AYA population. A developmentally informed approach to working with AYAs can elucidate unique strengths and vulnerabilities of this population and offer a new perspective on opportunities to respond to biopsychosocial barriers to adherence in a strengths-based, collaborative manner.
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Affiliation(s)
- Ashley Vandermorris
- Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
| | - Lorna Sampson
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Chana Korenblum
- Princess Margaret Cancer Centre, University Health Network, Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
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Cabannes‐Hamy A, Boissel N, Peffault De Latour R, Lengliné E, Leblanc T, Fontbrune FS, Raffoux E, Robin M, Xhaard A, Baruchel A, Socié G, Dhédin N. The effect of age in patients with acquired aplastic anaemia treated with immunosuppressive therapy: comparison of Adolescents and Young Adults with children and older adults. Br J Haematol 2018; 183:766-774. [DOI: 10.1111/bjh.15650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/08/2018] [Indexed: 01/27/2023]
Affiliation(s)
- Aurélie Cabannes‐Hamy
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
- University Paris DiderotParis France
| | - Nicolas Boissel
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
- University Paris DiderotParis France
| | - Régis Peffault De Latour
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
- University Paris DiderotParis France
| | - Etienne Lengliné
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
| | - Thierry Leblanc
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
- Department of Paediatric Haemato‐Oncology Robert Debré Hospital APHPParis France
| | - Flore S. Fontbrune
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
| | - Emmanuel Raffoux
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
| | - Marie Robin
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
| | - Aliénor Xhaard
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
| | - André Baruchel
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
- Department of Paediatric Haemato‐Oncology Robert Debré Hospital APHPParis France
| | - Gérard Socié
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
- Inserm UMR 1160 Paris France
| | - Nathalie Dhédin
- Department of Haematology CRNMR Aplastic Anaemia, Saint‐Louis Hospital APHPParis France
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Leader A, Raanani P. Switching-On Adherence in Chronic Myeloid Leukemia. Acta Haematol 2017; 138:138-139. [PMID: 28873366 DOI: 10.1159/000479484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Avi Leader
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, and Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel
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Jaime-Pérez JC, Jiménez-Castillo RA, Pinzón-Uresti MA, Cantú-Rodríguez OG, Herrera-Garza JL, Marfil-Rivera LJ, Gómez-Almaguer D. Real-world outcomes of treatment for acute lymphoblastic leukemia during adolescence in a financially restricted environment: Results at a single center in Latin America. Pediatr Blood Cancer 2017; 64. [PMID: 27957789 DOI: 10.1002/pbc.26396] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/27/2016] [Accepted: 11/14/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE There is a paucity of the studies of adolescents with acute lymphoblastic leukemia (ALL). This is more noticeable in low- and middle-income countries. The international 5-year event-free survival (EFS) and overall survival (OS) for this age group is around 80%, with pediatric-inspired protocols offering better results. METHODS A retrospective analysis of adolescents aged 16-20 diagnosed with ALL during the period 2004-2015 treated with a high-risk pediatric protocol at an academic center from a middle-income country was performed. Five-year OS and EFS were estimated by the Kaplan-Meier analysis. Hazard ratios of relapse and death were estimated by the Cox regression model. RESULTS Five-year EFS and OS for 57 adolescents were 23.3% and 48.9%, respectively. From the 41 patients who achieved complete remission, 24 (58.5%) relapsed. Bone marrow and central nervous system were the most frequent sites of relapse. Hazard ratio of treatment failure and death for patients with organomegaly at diagnosis was 2.026 and 2.970, respectively. Treatment-related toxicity developed in 31 (54.4%) patients and febrile neutropenia was the most frequent in 14 (24.6%) cases. Twelve patients (21.1%) had poor adherence to treatment. CONCLUSIONS High relapse rate and low 5-year EFS compared with international standards, was documented. Use of intensified pediatric regimens, adherence to proven effective medications, improved supportive care, and prevention of abandonment are necessary to improve survival rates in these patients.
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Affiliation(s)
- José C Jaime-Pérez
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Raúl A Jiménez-Castillo
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Mónica A Pinzón-Uresti
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Olga G Cantú-Rodríguez
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - José L Herrera-Garza
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Luis J Marfil-Rivera
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - David Gómez-Almaguer
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
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Bourlon C, Hernandez-Mata C, Vargas-Serafín C, Bourlon MT, Tuna-Aguilar E, Aguayo A. Fluorescent In Situ Hybridization Monitoring and Effect of Detected Early Responses in the Outcome of Patients With Chronic Phase Chronic Myeloid Leukemia: A Report From a Latin American Country. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2016; 16:453-9. [PMID: 27259590 DOI: 10.1016/j.clml.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The cytogenetic hallmark of chronic myeloid leukemia (CML) is the Philadelphia chromosome. Monitoring the response in patients receiving therapy is a standard of care. The present study was conducted to assess the monitoring adherence and reliableness of fluorescent in situ hybridization (FISH) as a monitoring tool and the effect of a complete cytogenetic response (CCyR) assessed by FISH on the prognosis of patients in a chronic phase (CP)-CML cohort. MATERIALS AND METHODS We retrospectively analyzed the data from 63 newly diagnosed CP-CML patients treated with imatinib mesylate at a dose of 400 mg/day as frontline therapy. The clinical data and cytogenetic test results at diagnosis and during monitoring were collected. The cytogenetic monitoring adherence assessment rates were measured. A correlation between chromosome banding analysis (CBA) and FISH was performed. The CCyR assessed by FISH was defined as < 1% BCR-ABL1(+) nuclei. The Kaplan-Meier method was used for overall survival analysis and time-to-event estimates. RESULTS The cytogenetic monitoring assessment adherence was 50.8% at 3 months, 93.5% at 6 months, 96.7% at 12 months, and 88.6% at 18 months. The Pearson correlation coefficient showed a significantly positive association (r = 0.84; P < .001) between CBA and FISH. The median follow-up duration after imatinib mesylate initiation was 60 months. A CCyR was achieved in 90.4% of patients within the first 18 months of therapy. At 3 months, 31 patients underwent a FISH evaluation, and 13 (41.9%) had achieved a CCyR. The patients who did not achieve a CCyR at 3 months had a significantly inferior probability of 5-year failure-free survival (38% vs. 94%; P = .001) and progression-free survival (80% vs. 100%; P = .043) compared with those with a CCyR. CONCLUSION We found improved monitoring adherence compared with the previous reports of Latin American populations. In countries with a high incidence of failure for CBA and a lack of real-time polymerase chain reaction standardization, FISH is a sensitive monitoring tool. In our cohort, patients not achieving an early CCyR, as tested by FISH, were a poor prognosis subgroup with worse rates of failure-free survival and progression-free survival.
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Affiliation(s)
- Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Carlos Hernandez-Mata
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Cesar Vargas-Serafín
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - María T Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Elena Tuna-Aguilar
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Alvaro Aguayo
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México.
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Abstract
Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous research suggests that psychosocial interventions specifically designed for AYA patients are promising, but studies of psychopharmacology treatments for depression are lacking. There is a pressing need for prospective studies and controlled clinical trials that evaluate the optimal strategies for treating depression in this patient group.
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Affiliation(s)
- Eliza M Park
- Department of Psychiatry University of North Carolina, Chapel Hill, North Carolina, USA
| | - Donald L Rosenstein
- Department of Psychiatry and Department of Medicine University of North Carolina, Chapel Hill, North Carolina, USA
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