An exploratory case study of the physical, emotional, and social factors that influence colorectal cancer patients’ adherence to oral chemotherapy treatment in South Wales.

Ali, Abdiraheem 2022. An exploratory case study of the physical, emotional, and social factors that influence colorectal cancer patients’ adherence to oral chemotherapy treatment in South Wales. PhD Thesis, Cardiff University.

Preview	PDF - Accepted Post-Print Version Download (3MB) | Preview
Preview	PDF (Cardiff University Electronic Publication Form) - Supplemental Material Download (1MB) | Preview

Abstract

Introduction: Colorectal cancer is the second most prevalent cancer in men and the third most prevalent in women in Wales. The increased use of oral chemotherapy agents and the convenience it brings to a patient’s routine have shifted treatment management closer to home, providing greater patient autonomy. Poor adherence remains a key barrier to achieving optimal treatment outcomes. The aim of this South Wales study was to explore the factors that influence colorectal cancer patients’ adherence to oral chemotherapy medicines and examine their beliefs about medication-taking. Method: Patients diagnosed with colorectal cancer and prescribed oral chemotherapy medications were recruited from an outpatient clinic. An exploratory single case study was used with two embedded units of analysis. Patient questionnaires (n=59) collected data including sociodemographic characteristics, self-reported adherence, and beliefs about medicines. A purposive sample of participants were followed up for semi-structured interviews (n=16) to explore their experiences and challenges with medication adherence. Transcripts were analysed using the framework method of analysis. Results: Self-reported adherence using the Medication Adherence Report Scale (MARS) indicated high adherence scores to oral chemotherapy agents. The Beliefs about Medicine Questionnaire (BMQ) indicated that patient beliefs in treatment necessity outweighed their concerns (99.3% vs. 44.1%). The Framework method of analysis identified five themes: therapy-related, patient-related, condition-related, healthcare system-related, and socioeconomic-related factors. Medication non-adherence was primarily related to forgetfulness and the adverse effects of oral chemotherapy agents. The findings also revealed that participants experienced negative emotions and identified contributing factors on medication-taking behaviours, including medication side effects, initial distress after learning about treatment needs, forgetting a dose, and malaise about the effectiveness of the medicine. Conclusion: CRC patients should be made aware of how to recognise potential side effects early, as timely management may prevent non-adherence to the oral chemotherapy medication. Clinicians should be mindful of patient preferences, promote practical methods for remembering to take medication doses, and engage in constructive conversations about information available online. Specific limitations of the MARS scale and its applicability to the CRC patient population were identified. Patients from deprived communities and/or those experiencing negative emotions require an interventional approach targeting areas such as medication beliefs, financial and welfare support, family and social support, and health awareness. This study also implies that developing a pre-screening tool to identify medication-related issues and psychological distress may help patients most in need of additional information, education, and adherence support.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	26 June 2023
Last Modified:	06 Jan 2024 04:25
URI:	https://orca.cardiff.ac.uk/id/eprint/160569

Actions (repository staff only)

Edit Item