TY - JOUR A1 - Hefner, Jochen A1 - Berberich, Sara A1 - Lanvers, Elena A1 - Sanning, Maria A1 - Steimer, Ann-Kathrin A1 - Kunzmann, Volker T1 - New insights into frequency and contents of fear of cancer progression/recurrence (FOP/FCR) in outpatients with colorectal carcinoma (CRC) receiving oral capecitabine: a pilot study at a comprehensive cancer center JF - Patient Preference and Adherence N2 - Background: Fear of cancer progression/recurrence (FOP/FCR) is considered one of the most prevalent sources of distress in cancer survivors and associated with lower quality of life and functional impairment. Detailed measures of FOP/FCR are needed because little is known about the knowledge of FOP/FCR, its associations with the patient–doctor relationship, and the rate of adequate therapy. Colorectal cancer (CRC) is one of the most prevalent cancer entities, and oral capecitabine is widely prescribed as treatment. Therefore, we initiated a pilot study to expand the literature on FOP/FCR in CRC outpatients receiving capecitabine and to generate hypotheses for future investigations. Methods: This study included 58 patients treated at a comprehensive cancer center. FOP/FCR was assessed with the Fear of Progression Questionnaire (FOP-Q-SF). Satisfaction with the relationships with doctors was assessed with the Patient–Doctor Relationship Questionnaire-9 (PRDQ-9). Levels of side effects were rated by the patients on a visual analog scale. Clinical data were extracted from the charts. Results: A total of 19 out of 58 patients (36%) suffered from FOP/FCR according to our assessment. Levels of FOP/FCR seemed to be mostly moderate to high. Only four out of the 19 distressed patients (21%) were treated accordingly. Typical side effects of oncological treatment were associated with higher FOP/FCR. Satisfaction with doctor–patient relationships was not associated with FOP/FCR. Regarding single items of FOP/FCR, three out of the five most prevalent fears were associated with close relatives. Discussion: FOP/FCR occurred frequently in more than one in three patients, but was mostly untreated in this sample of consecutive outpatients with CRC receiving oral capecitabine. In detail, most fears were related to family and friends. In addition to an unmet need of patients, our data indicate sources of distress not considered thus far. If replicated in larger studies, results may help to inform intervention development and improve patient care. KW - fear of progression KW - comprehensive management KW - oral anticancer drugs KW - colorectal cancer KW - screening for distress Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-158476 VL - 11 ER - TY - JOUR A1 - Hefner, Jochen A1 - Berberich, Sara A1 - Lanvers, Elena A1 - Sanning, Maria A1 - Steimer, Ann-Kathrin A1 - Kunzmann, Volker T1 - Patient-doctor relationship and adherence to capecitabine in outpatients of a German comprehensive cancer center JF - Patient Preference and Adherence N2 - Purpose: The prescribing of oral chemotherapy agents has introduced the new challenge of ensuring patients’ adherence to therapy. Aspects of a close patient–doctor relationship are reported to be correlated with adherence to oral anticancer drugs, but data on capecitabine are scarce. Patients and methods: Sixty-four outpatients with a diagnosis of cancer and prescribed capecitabine were recruited from a German Comprehensive Cancer Center. We used the Patient–Doctor Relationship Questionnaire (PDRQ-9), the Medical Adherence Rating Scale (MARS), the Beliefs about Medicines Questionnaire (BMQ), and the Satisfaction with Information about Medicines Scale (SIMS) to assess patients’ perceptions and behavior. Medical data were extracted from the charts. Results: Non-adherence was reported by 20% of the 64 participants. The perceived quality of the patient–doctor relationship was high in general, but it did not emerge as a predictor of adherence in our survey (odds ratio [OR]=0.915, P=0.162, 95% CI=0.808–1.036). However, beliefs about medicine (OR=1.268, P<0.002; 95% CI=1.090–1.475) as well as satisfaction with information about medicine (OR=1.252, P<0.040, 95% CI=1.010–1.551) were predictors of adherence and the quality of the patient–doctor relationship was correlated with both variables (r=0.373, P=0.002 for SIMS sum score; r=0.263, P=0.036 for BMQ necessity/concern difference). Overall, adherence to capecitabine was high with a conviction that the therapy is necessary. However, concerns were expressed regarding the long-term effect of capecitabine use. Patients have unmet information needs regarding interactions of capecitabine with other medicines and the impairment of their intimate life. Conclusions: In order to ensure adherence to capecitabine, our results seem to encourage the default use of modern and perhaps more impersonal means of information brokerage (eg, email, internet). However, the contents of some of patients’ informational needs as well as the associations of patients’ beliefs and satisfaction about the information received suggest a benefit from a trustful patient–doctor relationship. KW - oral anticancer drugs KW - patient-doctor-relationship KW - capecitabine Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-177143 VL - 12 ER - TY - THES A1 - Berberich, Sara T1 - Adhärenz bei oraler Capecitabin-Therapie : Zusammenhänge mit Progredienzangst T1 - Adherence to oral capecitabine therapy : connections with fear of progression N2 - Krebserkrankungen stellen eine lebensverändernde und potentiell letale Diagnose dar. Orale Zytostatika stellen eine vielversprechende Therapiemöglichkeit dar. Ein häufig eingesetztes orales Zytostatikum ist Capecitabin. Durch den Einsatz von oralen Chemotherapeutika ergeben sich viele Vorteile. Grundlegende Voraussetzung für den Einsatz der Tablettenform ist allerdings eine äquivalente Wirksamkeit. Diese hängt entscheidend von ausreichender Adhärenz der Patienten ab. In dieser Studie konnte bei der Auswertung des MARS-D gezeigt werden, dass 25 % der Studienteilnehmer nicht ausreichend adhärent waren. Häufigster Grund für Nicht-Adhärenz war das Vergessen der Medikamenteneinnahme. Ein weiteres, wichtiges Ergebnis dieser Pilotstudie war, dass die Probanden ihre Adhärenz subjektiv deutlich höher einschätzten (M im VAS 97,72) als sich bei der Auswertung des MARS-D bestätigen ließ. Die Erkennung und Behandlung psychischer Beeinträchtigungen und Erkrankungen ist bei der Betreuung von Krebspatienten entscheidend. Fear of progression (FOP) ist die am häufigsten geäußerte Angst von Krebspatienten. Diese Studie konnte die Bedeutung von FOP deutlich zeigen: bei 38 % der Probanden konnte eine dysfunktionale Form der FOP nachgewiesen werden. Nur vier Studienteilnehmer nutzten allerdings psychosomatische/psychiatrische Unterstützungmöglichkeiten. Die Single-Item Analyse des PA-F-KF zeigten sich Ängste im Vordergrund stehend, welche den Bereich Familie betrafen. Überraschenderweise ließ sich zwischen der häufigsten Nebenwirkung Hand-Fuß-Syndrom und FOP kein signifikanter Zusammenhang nachweisen. Dagegen konnten stark signifikante Zusammenhänge zwischen dem Auftreten von Diarrhoen, Übelkeit, Erschöpfung und dysfunktionaler FOP gezeigt werden. N2 - Cancer is life changing and possibly deadly. Oral anticancer drugs are promising. A common anticancer drug is Capecitabine. The use of oral chemotherapeutic medication results in many advantages. Precondition for similar effectiveness of tablets is good adherence. In this study the analysis of the MARS-D showed, that 25 % of the participants were non-adherent. The most important reason was forgetting to take the medication. Another important result of this study was, that subjective adherence was much higher than the objective MARS-D showed. Recognizing and treating psychological burdens and diseases of cancer patient is crucial. Fear of progression (FOP) is the most common fear of cancer patients. This study showed the importance of FOP: 38 % of the participants showed a dysfunctional FOP. Only four patients used psychosomatic/psychiatric support possibilities. The single-item analysis of the PA-F-KF showed, that the most important fears were about family. Surprisingly, there was no correlation found between the most common side effect hand foot syndrome and FOP. But we could show a strong significant correlation between diarrhea, nausea, fatigue and dysfunctional FOP. KW - Zukunftsangst KW - Adhärenz KW - Progredienzangst KW - Capecitabin KW - adherence KW - fear of progression KW - fear of cancer KW - recurrence KW - capecitabine Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-209800 ER -