Adherence to treatment in patients with solid and hematological cancers. Could spiritual and psychological support facilitate optimal adherence?

ABSTRACT – Objective: Cancer-related diseases pose a substantial public health challenge; however, recent treatments have enhanced patient outcomes. Adherence to therapy is crucial, and research focuses on elucidating the factors that influence it. Limited information exists on medication adherence in cancer patients. This study aims to identify risk factors for non-adherence in a cohort of people with solid and hematological tumors. Participants and Methods: This is a cross-sectional study in which participants were recruited from two Oncologic hospital units in Italy. The inclusion criteria were age ≥ 18 years, confirmed malignant neoplasm, and active treatment. Data included sociodemographic and clinical-oncological factors. Treatment adherence was assessed through a clinician-based dichotomous scale. Health-related quality of life (HRQoL) was evaluated with the Short Form Health Survey – 12 items (SF-12), satisfaction with care was measured using the Treatment Perception Questionnaire. Results: A total of 263 participants (132 females, 50.2%) was involved in this study. The mean age was 61.2±13.8. Non-adherence frequency was 9.9%. Factors associated with non-adherence were shorter time since care initiation (<6 months), receiving palliative care, having a solid cancer diagnosis. Non-adherence was higher in solid cancer (12.4%) compared to hematologic cancer (1.6%). In the combination of risk factors, a significant association was found between unemployment/high level of education and non-adherence. Conclusions: The study found a low non-adherence rate to oncological treatments, possibly due to strong psychological and spiritual support. However, individuals with higher education and unemployment showed specific non-adherence risk, necessitating attention to their emotional challenges while facing cance