title: Are Australian clinicians monitoring medication adherence in hematological cancer survivors? Two cross-sectional studies.
abstract: BACKGROUND
  Hematological cancer survivors are growing in number and increasingly rely on oral therapy. Given known poor outcomes associated with non-adherence and previous evidence that many patients do not fully adhere to their treatment regimen, this study aimed to determine the degree to which clinicians monitor adherence to oral medication in hematological cancer survivors.
  
  
  METHODS
  Data was combined from two cross-sectional surveys of a heterogeneous sample of 431 hematological cancer survivors recruited from three outpatient hematology clinics in three different states (n = 215) and one state cancer registry (n = 216) in Australia. Participants completed a self-administered survey that included demographic characteristics and a 7-item measure of medication adherence developed by the researchers specifically for the purpose of the studies.
  
  
  RESULTS
  Of the 431 participants, 37 % (n = 160) reported currently taking daily cancer-related medication. Of these, 14 % (n = 23) were found to be non-adherent with 'missing a dose' being the most commonly reported non-adherent behaviour. Only 41 % of survivors indicated that their hematologist or cancer clinician had 'always' asked about their cancer-related medication during their last six visits.
  
  
  CONCLUSIONS
  Non-adherence to oral therapy remains a problem in hematological cancer survivors, yet clinicians in Australia do not appear to be regularly monitoring adherence in their patients. Given an increasing dependence on oral therapy in clinical hematology and medical oncology and the importance of medication adherence to optimising health outcomes, greater effort should be invested in developing effective interventions to improve support and adherence monitoring by cancer clinicians and GPs.
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4, West, HMRI Building, Callaghan, NSW 2308 Australia.
authors.forename: Marita C
authors.initials: MC
authors.lastname: Lynagh
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, 1127 Booth Building, Wallsend Campus, NSW 2308 Australia.
authors.forename: Tara
authors.initials: T
authors.lastname: Clinton-McHarg
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4, West, HMRI Building, Callaghan, NSW 2308 Australia.
authors.forename: Alix
authors.initials: A
authors.lastname: Hall
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4, West, HMRI Building, Callaghan, NSW 2308 Australia.
authors.forename: Rob
authors.initials: R
authors.lastname: Sanson-Fisher
authors.affiliation: Department of Haematology Royal North Shore Hospital Pathology North, The University of Sydney, Sydney, NSW 2006 Australia.
authors.forename: William
authors.initials: W
authors.lastname: Stevenson
authors.affiliation: School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4, West, HMRI Building, Callaghan, NSW 2308 Australia.
authors.forename: Campbell
authors.initials: C
authors.lastname: Tiley
authors.affiliation: The Clinical Research Design Information Technology and Statistical Support Unit (CReDITSS), The University of Newcastle, HMRI Building, Callaghan, Sydney, NSW 2308 Australia.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bisquera
keywords: Hematological cancer; Medication adherence; Oral therapy