Introduction/Significance: Medication beliefs are perceptions regarding the benefits and concerns of treatment that arise from cognitive representations of illness. They are critical to medication-taking behavior. Older adults have the highest incidence of solid tumors and are often prescribed oral anticancer agents (OAAs). OAAs offer undeniable convenience, however, patients face challenges managing cancer care at home.
Objective: To delve into the OAA medication beliefs among older adults, an underexplored area in oncology and geriatric care.
Methodology: This mixed-methods study employed the Beliefs about Medicines Questionnaire-Specific (BMQ) to elicit OAA perceptions. The BMQ has two Subscales: Necessity assesses beliefs about the need for prescribed medication and Concerns assesses negative effects of the medication. Responses are rated on a summed 5-point Likert-type scale, ranging from 1=strongly disagree to 5=strongly agree (range 5-25), with higher scores indicating stronger beliefs. Semi-structured interviews were conducted to gain a deeper understanding of medication beliefs. Interviews were audio-recorded and transcribed verbatim. A thematic analysis was completed. Cohen’s Kappa was used to evaluate inter-rater reliability (0.86). Descriptive statistics of the BMQ were calculated. Participants were recruited from a National Cancer Institute-designated Cancer Center and eligible if: 1) prescribed a Food and Drug Administration-approved OAA; 2) ≥ 65 years; 3) English speaking; and 4) able/willing to complete telephone interviews.
Results: Participants (N=30) had a mean age of 74.9 years, 70% were female, and 83.3% were White. Mean BMQ-Necessity scores ranged from 9-25 (mean of 19.1, SD 4.25), indicating strong beliefs that OAAs are vital for maintaining and improving health. BMQ-Concerns scores ranged from 5-23 (mean of 11.6, SD 4.50), indicating moderate hesitation regarding taking OAAs. Two main themes, both with corresponding subthemes, were revealed: 1) Benefits of OAAs (delayed disease progression & extended survival, and improving the symptoms of cancer) and 2) Risks of Taking OAAs (financial impact, symptoms/side effects).
Conclusion & Discussion: Participants have strong OAA Necessity beliefs, which outweigh their Concern beliefs. Concerns can be minimized if communicated early to oncology providers. Providers should assess patient concerns at every encounter as these beliefs can result in undesirable outcomes such as non-adherence.