Review of adherence-related issues in adolescents and young adults with cancer.
OBJECTIVE
This review aims to provide a broad overview of the issues and clinical challenges of nonadherence in adolescents and young adults (AYAs) with cancer. Nonadherence can reduce treatment efficacy, which places the patient at higher risk of relapse, adverse effects, and poor outcomes.


METHODS
A review of the English-speaking literature between 1980 and 2008 was conducted to identify relevant publications, which were supplemented by reference and author searches.


RESULTS
Definition and measurement of adherence varies. Most studies have not clearly delineated an AYA age group (ie, 15-25 years) and have been dominated by leukemia and lymphoma samples. Estimates for nonadherence in this population range from 27% to 60%, with openness of family relationships and support found to predict adherence. Strategies to avoid, assess, and manage nonadherence are presented.


CONCLUSIONS
Overall, the evidence base for adherence and strategies to promote it in AYAs with cancer is woefully lacking. There is a need for high-quality studies that target clinically important questions, randomized controlled trials of theoretically based interventions, and development and evaluation of training programs for oncology staff in the special issues faced by AYAs with cancer.
Butow
Phyllis
P
Centre for Medical Psychology and Evidence-Based Decision-Making, Research Group, University of Sydney, Sydney, New South Wales, Australia. phyllisb@psych.usyd.edu.au
Palmer
Susan
S
Pai
Ahna
A
Goodenough
Belinda
B
Luckett
Tim
T
King
Madeleine
M
D000293:Adolescent; D006801:Humans; D009369:Neoplasms / Q000523:psychology*; D010349:Patient Compliance; D055815:Young Adult