Exploration of contributing factors for nonadherence to breast Cancer treatment – a systematic review

Abstract

Background: Poor adherence to breast cancer treatment often poses the patient towards unfavourable health outcomes. On the contrary
consistencies in following treatment protocols have proven to flag up the manifold benefits of adherence. Breast cancer survivors do forego
treatment at times for various reasons that exposes them for the risk of cancer recurrences. This systematic review aims to explore the
contributing factors for non-adherence to breast cancer treatment. Methods: The study has been registered in PROSPERO. The review
included major database searches from PubMed, Ovid Medline and Web of science for relevant articles. The articles were meticulously
screened following PRISMA guidelines 2020 and a total of 21 studies which met the inclusion criteria were included out of the 113127 for the
review. Zotero reference manager was used to import and retrieve the studies. The included studies were assessed for methodological quality
using MMAT (mixed method appraisal tool) version 2018. Results: The collective findings of the studies have brought to focus the factors
for nonadherences such as side-effects of treatment, cost, accessibility to health care, comorbidities, older age, beliefs & preferences,
knowledge about treatment, online information overload, forgetfulness, use of multiple medications, educational level and patient healthcare
provider relationship. Conclusion: Nonadherences to breast cancer treatment is multifactorial. Health care providers team-based approach is
essential to manage the diverse factors influencing nonadherence to breast cancer treatment. Nurses catering for patients can collaborate
develop strategies, policies and manage individual patient concerns to ensure adherence and improve treatment outcomes.