Leah L Zullig1,2,3, Connor Drake4, Mohammad Shahsahebi5, Renee A V Avecilla5, Colette Whitney5, Coleman Mills5, Kevin C Oeffinger5. 1. Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, 411 West Chapel Hill Street, Suite 600, Durham, NC, 27701, USA. leah.zullig@duke.edu. 2. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA. leah.zullig@duke.edu. 3. Center for Onco-Primary Care, Duke Cancer Institute, Durham, NC, USA. leah.zullig@duke.edu. 4. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA. 5. Center for Onco-Primary Care, Duke Cancer Institute, Durham, NC, USA.
Abstract
PURPOSE: The most common cause of mortality for many cancer survivors is cardiovascular disease (CVD). This requires a shift in thinking where control of CVD risk factor-related comorbidity is paramount. Our objective was to provide an understanding of adherence to medications for the management of CVD risk factor-related comorbidities among cancer survivors. METHODS: We systematically searched for articles indexed in MEDLINE (via PubMed), Embase, Cochrane (Wiley), PsycINFO, and Scopus (via Elsevier) for articles published from inception to October 31, 2019, and updated the search on June 7, 2021. English language, original research that assessed medication adherence to common CVD risk factor-related comorbidities among cancer survivors was included. We assessed risk of bias using the Mixed Methods Appraisal Tool. RESULTS: Of the 21 studies included, 57% focused on multiple cancer types. Seventy-one percent used pharmacy-based adherence measures. Two were prospective. Adherence was variable across cancer types and CVD risk factor-related comorbidities. Among the studies that examined changes in comorbid medication adherence, most noted a decline in adherence following cancer diagnosis and throughout cancer treatment. There was a focus on breast cancer populations. CONCLUSIONS: CVD risk factor-related medication adherence is low among cancer survivors and declines over time. Given the risk for CVD-mortality among cancer survivors, testing of interventions aimed at improving adherence to non-cancer medications is critically needed. IMPLICATIONS FOR CANCER SURVIVORS: For many cancer survivors, regularly taking medications to manage CVD risk is important for longevity. Engaging with primary care throughout the cancer care trajectory may be important to support cardiovascular health.
PURPOSE: The most common cause of mortality for many cancer survivors is cardiovascular disease (CVD). This requires a shift in thinking where control of CVD risk factor-related comorbidity is paramount. Our objective was to provide an understanding of adherence to medications for the management of CVD risk factor-related comorbidities among cancer survivors. METHODS: We systematically searched for articles indexed in MEDLINE (via PubMed), Embase, Cochrane (Wiley), PsycINFO, and Scopus (via Elsevier) for articles published from inception to October 31, 2019, and updated the search on June 7, 2021. English language, original research that assessed medication adherence to common CVD risk factor-related comorbidities among cancer survivors was included. We assessed risk of bias using the Mixed Methods Appraisal Tool. RESULTS: Of the 21 studies included, 57% focused on multiple cancer types. Seventy-one percent used pharmacy-based adherence measures. Two were prospective. Adherence was variable across cancer types and CVD risk factor-related comorbidities. Among the studies that examined changes in comorbid medication adherence, most noted a decline in adherence following cancer diagnosis and throughout cancer treatment. There was a focus on breast cancer populations. CONCLUSIONS: CVD risk factor-related medication adherence is low among cancer survivors and declines over time. Given the risk for CVD-mortality among cancer survivors, testing of interventions aimed at improving adherence to non-cancer medications is critically needed. IMPLICATIONS FOR CANCER SURVIVORS: For many cancer survivors, regularly taking medications to manage CVD risk is important for longevity. Engaging with primary care throughout the cancer care trajectory may be important to support cardiovascular health.
Authors: Hannah Arem; Ruth M Pfeiffer; Steven C Moore; Louise A Brinton; Charles E Matthews Journal: Cancer Causes Control Date: 2016-10-11 Impact factor: 2.506
Authors: Nikola S Mutschler; Christoph Scholz; Thomas W P Friedl; Thomas Zwingers; Peter A Fasching; Matthias W Beckmann; Tanja Fehm; Svjetlana Mohrmann; Jessica Salmen; Carola Ziegler; Bernadette Jäger; Peter Widschwendter; Nikolaus de Gregorio; Fabienne Schochter; Sven Mahner; Nadia Harbeck; Tobias Weissenbacher; Julia Jückstock; Wolfgang Janni; Brigitte Rack Journal: Clin Breast Cancer Date: 2018-01-31 Impact factor: 3.225
Authors: Annette Y Sunga; Margaret M Eberl; Kevin C Oeffinger; Melissa M Hudson; Martin C Mahoney Journal: Am Fam Physician Date: 2005-02-15 Impact factor: 3.292
Authors: Jersey Chen; Jessica B Long; Arti Hurria; Cynthia Owusu; Richard M Steingart; Cary P Gross Journal: J Am Coll Cardiol Date: 2012-11-14 Impact factor: 24.094
Authors: Kristin L Campbell; Kerri M Winters-Stone; Joachim Wiskemann; Anne M May; Anna L Schwartz; Kerry S Courneya; David S Zucker; Charles E Matthews; Jennifer A Ligibel; Lynn H Gerber; G Stephen Morris; Alpa V Patel; Trisha F Hue; Frank M Perna; Kathryn H Schmitz Journal: Med Sci Sports Exerc Date: 2019-11 Impact factor: 5.411