Improving Patient Adherence To Cancer Treatment Ell, Kathleen R. Cancer Control Research; National Cancer Institute
Improving Adherence To Cancer Treatment
Excerpt From Abstract of Proposal:
Studies of adherence to cancer treatment find that low-income and minority population experience important barriers (including access barriers) to optimal treatment adherence behavior (helping to explain less favorable morbidity and mortality cancer outcomes among women living in poverty). A randomized clinical trial is proposed to test the efficacy of a multifaceted intervention on patient adherence to breast and gynecological adjuvant cancer treatment and post-treatment follow-up among low-income minority women. The proposed study will test the efficacy of a culturally tailored intervention model that combines interactive health education (decisional support), counseling (emotional support), and systems navigation (resource access) interventions that have been shown to be effective in enhancing adherence to abnormal screening diagnostic follow-up among low-income minority women. The efficacy of IMPAACT1will be tested by comparing adherence outcomes between intervention and modestly enhanced usual care group patients. The nature of relationships between assessed barriers, adherence outcomes, and quality of life outcomes and patient satisfaction with the intervention and with their cancer care will be identified. In addition, the study will test models specifying direct, indirect, and intervening relationships between assessed barriers and adherence behaviors within intervention and control groups. In addition, estimates of direct costs of the intervention and usual care arms will be compared.
Commentary
While this research is, as far as I can determine, ongoing and no preliminary report has been issued,2 the paucity of clinical investigations of culturally tailored interventions to enhance compliance - and, more pertinently, tailored compliance enhancement methods of any sort - prompts me to note this project’s existence and express hopes that results will soon be available.
Update: Information about the status of this project obtained via personal communication with the project’s Director is available at Status Of Improving Patient Adherence To Cancer Treatment Project
Footnotes
- Although it is not specified in the abstract, I assume IMPAACT refers to Improving Patient Access and Adherence to Cancer Treatment, the National Cancer Institute-funded clinical trial of a system of structured interventions based on the case management model applied to 500 women with breast or gynecological cancer with the goal of improving compliance to cancer treatment.↩
- I did find (1) a reference to a presentation, “IMPAACT: Improving Patient Access and Adherence to Cancer Treatment. Barriers to Treatment Adherence in Minorities and Persons Living in Poverty” at the National Institutes of Health Conference, Bethesda, Maryland, February, 2006, but was unable to locate any publication of this material and (2) a summary of a presentation, Reducing Disparity in Recruitment of Ethnic Minority Patients in Cancer Clinical Trials: A Priority in Enhancing Culturally Competent Practice made 13 January 2007 at the Society for Social Work and Research meeting, Bridging Disciplinary Boundaries. That paper, however, addressed “socio-culturally grounded strategies to enhance the recruitment of low-income, predominantly Latina women with cancer that have resulted in relatively high rates of participation in two NIH funded clinical trials of social work interventions.”↩