title: Predictors of radiation therapy noncompliance in an urban academic cancer center.
abstract: OBJECTIVE
  To quantify the frequency of patient noncompliance in an urban radiation oncology department and identify predictors of noncompliance.
  
  
  METHODS
  We identified patients treated with external beam radiation therapy (RT) with curative intent in our department from 2007 to 2012 for 1 of 7 commonly treated malignancies. Patients who missed 2 or more scheduled RT appointments were deemed "noncompliant." An institutional database was referenced to obtain clinical and demographic information for each patient, as well as a quantitative estimate of each patient's socioeconomic status. Logistic regression was used to identify factors associated with RT noncompliance.
  
  
  RESULTS
  A total of 2184 patients met eligibility criteria. Of these, 442 (20.2%) were deemed "noncompliant." On multivariate analysis, statistically significant predictors of noncompliance included diagnosis of head-and-neck, cervical, or uterine cancer, treatment during winter months, low socioeconomic status, and use of a long treatment course (all P<.05).
  
  
  CONCLUSIONS
  This is the first large effort examining patient noncompliance with daily RT. We have identified demographic, clinical, and treatment-related factors that can be used to identify patients at high risk for noncompliance. These findings may inform future strategies to improve adherence to prescribed therapy.
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Nitin
authors.initials: N
authors.lastname: Ohri
authors.affiliation: Department of Epidemiology & Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Rapkin
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Debayan
authors.initials: D
authors.lastname: Guha
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Hilda
authors.initials: H
authors.lastname: Haynes-Lewis
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Chandan
authors.initials: C
authors.lastname: Guha
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Shalom
authors.initials: S
authors.lastname: Kalnicki
authors.affiliation: Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address: mgarg@montefiore.org.
authors.forename: Madhur
authors.initials: M
authors.lastname: Garg
mesh_terms: D000047:Academies and Institutes; D001943:Breast Neoplasms / Q000532:radiotherapy; D002173:Cancer Care Facilities; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006297:Health Services Accessibility; D006801:Humans; D007802:Language; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D009369:Neoplasms / Q000208:ethnology / Q000532:radiotherapy*; D009519:New York City; D010349:Patient Compliance / Q000208:ethnology / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000532:radiotherapy; D012004:Rectal Neoplasms / Q000532:radiotherapy; D012044:Regression Analysis; D012621:Seasons; D012959:Socioeconomic Factors; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy; D014594:Uterine Neoplasms / Q000532:radiotherapy