Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Patient preferences regarding oral anti-cancer therapy: a systematic review. (#281)

Amy Davies 1 , Daniel Buckley 1 , Ajay Raghunath 1 , Karina Martin 1 , Hans Prenen 2 , Olivia Cook 3 , Eva Segelov 1 4
  1. Department of Medical Oncology, Monash Health, Melbourne, VIC, Australia
  2. Department of Oncology, University Hospital Antwerp, Edegem, Belgium
  3. Monash Nursing and Midwifery, Monash University, Melbourne, Victoria
  4. Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia


Oral anti-cancer therapies are now commonplace in cancer treatment. Variable adherence is concerning, particularly for treatments with curative intent. This study reviews literature on patient preferences considering: 1) factors contributing to patient adherence; 2) benefits and limitations; 3) concordance between patient and clinician perspectives.  



This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An a priori protocol was established with systematic searches of major databases (Pubmed, Ovid Emcare, CINAHL and Scopus) from 2000 - 2020. Quantitative and qualitative studies of adult populations were included. Methodological quality was assessed using the Johanna Briggs Institute Critical Appraisal Tools. A narrative synthesis of findings was conducted.



1095 articles were screened. Following full-text review of 246 articles, 41 studies were included in the systematic review. Most studies (38/41, 93%) involved patients from USA and Europe; there were no Australian-based studies. The methodological quality of most studies (37/41, 90%) was ‘moderate’ to ‘high’. Most high quality studies (15/19, 80%) were reported in the past ten years. Factors contributing to lower adherence were: less patient education, lack of habitual administration, avoidance of side effects and reduced understanding of oral regimens. Benefits were: convenience of home administration, patient empowerment, better psychological wellbeing, and less social and productivity interruption when compared with intravenous administration. Limitations included reactive management of side-effect due to reduced contact with clinicians, as well as difficulty obtaining oral chemotherapy at community-based pharmacies. Pharmaceutical interventions were shown to improve adherence. Studies comparing patient and clinician perspectives (n= 4) identified a lack of relevant toxicity education.



Barriers and enablers of oral anticancer treatment have been identified. This information should be used by clinicians to optimise this mode of cancer treatment.