Nitin Ohri1, Bruce D Rapkin2, Debayan Guha1, Hilda Haynes-Lewis1, Chandan Guha1, Shalom Kalnicki1, Madhur Garg3. 1. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. 2. Department of Epidemiology & Population Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. 3. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address: mgarg@montefiore.org.
Abstract
PURPOSE: To quantify the frequency of patient noncompliance in an urban radiation oncology department and identify predictors of noncompliance. METHODS AND MATERIALS: 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). CONCLUSION: 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.
PURPOSE: To quantify the frequency of patient noncompliance in an urban radiation oncology department and identify predictors of noncompliance. METHODS AND MATERIALS: 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). CONCLUSION: 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.
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