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Impact of anxio-depressive symptoms and cognitive function on oral anticancer therapies adherence

  • Mélanie Dos SantosEmail author
  • M. Lange
  • R. Gervais
  • B. Clarisse
  • A. Capel
  • M. Barillet
  • J. M. Grellard
  • N. Heutte
  • I. Licaj
  • F. Joly
Original Article

Abstract

Purpose

Oral anticancer therapies have an important place in the therapeutic arsenal, but factors influencing adherence to oral treatment are poorly documented in oncology. The objective of this study was to assess the impact of anxio-depressive symptoms and cognitive functioning on oral medication adherence.

Methods

This prospective study included cancer patients initiating a first oral therapy. Before initiation of treatment, an assessment of depression, anxiety, and cognition was performed. Using self-report questionnaires, we collected information on socio-demographic conditions and the non-adherence at 1 (M1) and 3 months (M3) after the beginning of treatment.

Results

Among 129 patients enrolled, median age was 70 years and 81% of patients were treated for metastatic cancer. Before initiating treatment, 16% and 8% of patients presented respectively depression and anxiety symptoms. Global cognitive impairment was observed in 51% of patients. Ten percent of the patients were non-adherent at M1 and 13% at M3. Depression was strongly associated with non-adherence at M1 (P = 0.046) and M3 (P = 0.014), but not anxiety. Non-adherence was associated with lower working memory (P = 0.037) and digit memory (P = 0.018) at M1 and short-term memory (P = 0.04) at M3. Patients with more than eight co-medications were more often non-adherents (P = 0.055).

Conclusions

Non-adherence to oral anticancer therapies was mainly associated to depression. Focusing on depressive symptoms before initiation of oral anticancer therapy could help to identify patient profiles more likely to fail self-management. Working memory, digit memory, and short-term memory also seem to play a role in non-adherence. Further studies should include a more specific population, especially according to age.

Keywords

Adherence Cancer Depression Anxiety Cognitive function 

Notes

Acknowledgments

The authors would like to thank all patients who generously participated in this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Clinical Research Department, Centre François BaclesseCaenFrance
  2. 2.Department of MedicineHospital UniversityCaenFrance
  3. 3.Department of Medical Oncology, Centre François BaclesseCaenFrance
  4. 4.INSERM, U1086, ANTICIPECaenFrance

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