GERİATRİK ONKOLOJİ HASTALARINDA TEDAVİYE UYUM

Öz

Bu çalışma, küresel yaşlanma artışının ortasında yaşlı nüfusta kanser tedavisine bağlılığı değerlendirmeye odaklanmaktadır. Yaşlanma ve kanser arasındaki ilişki tam olarak anlaşılmamış olsa da, birbirlerini etkilediklerine inanılmaktadır. Yaşlılarda sık görülen kanserler arasında meme, akciğer, prostat ve kolorektal kanser yer almaktadır. Bu çalışma, yaşa bağlı kanserler için tedaviye uyumu değerlendirmeyi ve etkileyen faktörleri belirlemeyi amaçlamaktadır. Tedavinin etkinliği için çok önemli olan tedaviye bağlılık, yaşlılarda genç bireylere kıyasla daha düşük bulunmuştur. Bağlılığı etkileyen faktörler arasında yaş, cinsiyet, sosyoekonomik durum, komorbiditeler, tedavi süresi ve polifarmasi yer almaktadır. Sosyal destek eksikliği ve polifarmasi uyumsuzluğa katkıda bulunmaktadır. Yaşa bağlı hastalıkların artmasıyla birlikte polifarmasi daha yaygın hale gelmekte ve sosyal desteğe duyulan ihtiyacı vurgulamaktadır. Yaşla birlikte kanseri etkili bir şekilde yönetmek için bağlılığı artırmak hayati önem taşımaktadır. Ancak çalışmalar, birçok yaşlı bireyin polifarmasi ve destek eksikliği nedeniyle tedaviye uymakta zorlandığını ve bunun da sağkalımlarını etkilediğini ortaya koymaktadır. Çok az sayıda çalışma, yaşlı kanser hastalarında tedaviye uyuma odaklanmakta ve hasta sonuçlarını iyileştirmek için bu alanda daha fazla araştırma yapılması gerektiğini vurgulamaktadır.

Anahtar Kelimeler

• geriatrik
• tedaviye uyum
• kanser
• onkoloji
• hemşire

Adherence to Treatment in Geriatric Oncology Patients

Öz

This study focuses on assessing cancer treatment adherence in the elderly population amidst the global increase in aging. While the relationship between aging and cancer is not fully understood, they are believed to influence each other. Common cancers in the elderly include breast, lung, prostate, and colorectal cancer. The study aims to evaluate adherence to treatment for age-related cancers and identify influencing factors. Treatment adherence, crucial for treatment effectiveness, is found to be lower in the elderly compared to younger individuals. Factors affecting adherence include age, gender, socioeconomic status, comorbidities, treatment duration, and polypharmacy. Lack of social support and polypharmacy contribute to non-adherence. With the rise in age-related diseases, polypharmacy becomes more common, emphasizing the need for social support. Enhancing adherence is vital for managing cancer effectively with age. However, studies reveal that many elderly individuals struggle to adhere to treatment due to polypharmacy and lack of support, impacting their survival. Few studies focus on treatment adherence in elderly cancer patients, highlighting the need for more research in this area to improve patient outcomes.

Anahtar Kelimeler

• geriatric
• treatment adherence
• cancer
• ncology
• nurse

Kaynakça

1. Alan, Ö., Gürsel, Ö., Ünsal, M., Altın, S., & Kılçıksız, S. (2013). Oncologic approach in geriatric patients. Okmeydanı Medical Journal, 29(Suppl 2), 94-98. https://doi.org/10.5222/otd.supp2.2013.094
2. American Cancer Society (ACSa). (2023). Recommendations for the early detection of breast cancer. Retrieved February 21, 2023, from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
3. American Cancer Society (ACSb). (2023). Can lung cancer be found early? Retrieved February 21, 2023, from https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/detection.html
4. American Cancer Society (ACSc). (2023). Prostate cancer. Retrieved February 21, 2023, from https://www.cancer.org/cancer/prostate-cancer.html
5. American Cancer Society (ACSd). (2023). Cancer A-Z. Retrieved February 21, 2023, from https://www.cancer.org/cancer.html
6. Antonio, M., Carmona-Bayonas, A., Saldaña, J., Navarro, V., Tebé, C., Salazar, R., & Borràs, J. M. (2018). Factors Predicting Adherence to a Tailored-Dose Adjuvant Treatment on the Basis of Geriatric Assessment in Elderly People with Colorectal Cancer: A Prospective Study. Clinical colorectal cancer, 17(1), e59–e68. https://doi.org/10.1016/j.clcc.2017.09.003
7. Aydos, R. T. (2021). Drug compliance and telemedicine applications in elderly individuals. In Y. G. Kutsal & D. Aslan (Eds.), Telemedicine, aging, and telemedicine applications pp. 49-68. Turkish Geriatrics Society. https://aperta.ulakbim.gov.tr/record/263392
8. Ayvat, İ., & Atlı Özbaş, A. (2021). Supportive care needs of elderly cancer patients: Are the needs aging too? Hacettepe University Faculty of Nursing Journal, 8(1), 93-100.

9. Aytulu, T., Selcukbiricik, F., Calikoglu, F., Yilmaz, M., Ergene, G., Issever, H., & Satman, İ. (2022). Evaluation of sarcopenia, malnutrition and nutritional status of patients with and without cancer treatment by age. Journal of Advanced Research in Health Sciences, 5(1):6-13. https://doi:10.26650/JARHS2022-1035701
10. Berger, N. A., Savvides, P., Koroukian, S. M., et al. (2006). Cancer in the elderly. Transactions of the American Clinical and Climatological Association, 117, 147-156.
11. CCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Older Adult Oncology Version 1.2023. (2023). Retrieved February 21, 2023, from https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf
12. Chen, L. J., Nguyen, T. N. M., Chang-Claude, J., Hoffmeister, M., Brenner, H., & Schöttker, B. (2021). Association of Polypharmacy with Colorectal Cancer Survival Among Older Patients. The oncologist, 26(12), e2170–e2180. https://doi.org/10.1002/onco.13961
13. Çapar, E., & Çapar, A. (2018). Geriatric Issues in Elderly Dialysis Patients. J Geriatric Sci. 1(3), 119-125. https://dergipark.org.tr/en/pub/geriatrik/issue/41957/488502
14. Çor, Z., & Soysal, G. E. (2023). Rehabilitation for care in intensive care units. The Journal of Health Care and Rehabilitation, 2(1), 10-18.
15. Droz, J. P., Balducci, L., Bolla, M., et al. (2010). Management of prostate cancer in older men: Recommendations of a working group of the International Society of Geriatric Oncology. BJU International, 106(4), 462-469. https://doi.org/10.1111/j.1464-410X.2010.09334.x
16. Erkoç, Y., & Yardım, N. (2011). Non-communicable diseases and risk factors combat policies in Turkey. Retrieved from https://www.saglikaktuel.com/d/file/ulke_raporu_baski_hali_tr.pdf
17. Estapé, T. (2018). Cancer in the elderly: Challenges and barriers. Asia-Pacific Journal of Oncology Nursing, 5(1), 40-42. https://doi.org/10.4103/apjon.apjon_52_17
18. Fatima, J., Sadiq, S.M., Ahmed, S., Khan, R., Uddin, M.N. (2018). Patient Medication Adherence and the Health Outcome. Asian J Pharm Res,8(2):78-82.east.2020.05.008 https://doi:10.5958/2231-5691.2018.00013.8 Available on: https://asianjpr.com/AbstractView.aspx?PID=2018-8-2-3
19. General Directorate of Services for Disabled and Elderly. (2022). Statistical bulletin on disabled and elderly. Republic of Turkey, Directorate of Family and Social Services. Retrieved from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://aile.gov.tr/media/135432/eyhgm_istatistik_bulteni_nisan_23.pdf
20. González Serrano, A., Martínez Tapia, C., de la Taille, A., et al. (2021). Adherence to treatment guidelines and associated survival in older patients with prostate cancer: A prospective multicentre cohort study. Cancers, 13(18), 4694. https://doi.org/10.3390/cancers13184694
21. Graessle, R., Stromberger, C., Heiland, M., et al. (2022). Predictors for adherence to treatment strategies in elderly HNSCC patients. Cancers, 14(2), 423. https://doi.org/10.3390/cancers14020423
22. Güven, İ. (2021). Oro-dental problems in geriatric oncology patients (Master’s thesis). Istanbul University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery. Retrieved from http://nek.istanbul.edu.tr:4444/ekos/TEZ/ET003708.pdf
23. Hamine, S., Gerth-Guyette, E., Faulx, D., Green, B. B., & Ginsburg, A. S. (2015). Impact of mHealth chronic disease management on treatment adherence and patient outcomes: a systematic review. Journal of medical Internet research, 17(2), e52. https://doi.org/10.2196/jmir.3951
24. Ho, P. J., Ow, S. G. W., Sim, Y., et al. (2020). Impact of deviation from guideline recommended treatment on breast cancer survival in Asia. Scientific Reports, 10(1), 1330. https://doi.org/10.1038/s41598-020-58007-5
25. International Agency for Research on Cancer, Global Cancer Observatory. (2023). Retrieved February 21, 2023, from https://gco.iarc.fr/
26. Iuga, A. O., & McGuire, M. J. (2014). Adherence and health care costs. Risk management and healthcare policy, 7, 35–44. https://doi.org/10.2147/RMHP.S19801
27. İlçe, A., & Kuzay, H. (2023). Determination of techniques and methods given by caregivers in chronic wound healing, and the knowledge of caregivers at home. The Journal of Health Care and Rehabilitation, 2(1), 1-9.
28. İlhan, B., & Bakkaloğlu, O. K. (2019). Frailty and cancer screening rates in older adults. Journal of Istanbul Faculty of Medicine, 82(1), 24-28. https://doi.org/10.26650/IUITFD.2018.0030
29. Kenyon, J. D., Park, Y., Marcus, R. E., Goldberg, V. M., & Gerson, S. L. (2005). Human hematopoietic progenitor cells exhibit increased microsatellite instability associated with advanced age. Blood, 106, 643a.
30. Kiderlen, M., Walsh, P. M., Bastiaannet, E., et al. (2015). Treatment strategies and survival of older breast cancer patients: An international comparison between the Netherlands and Ireland. PLOS ONE, 10(2). https://doi.org/10.1371/journal.pone.0118074
31. Kurtkapan, H. (2018). Active aging and local government practices: The example of Istanbul. Senex: Journal of Aging Studies, 2(2), 38-52. https://doi.org/10.24876/senex.2018.13
32. Lin, J. S., Piper, M. A., Perdue, L. A., et al. (2016). Screening for colorectal cancer: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA, 315(23), 2576-2594. https://doi.org/10.1001/jama.2016.3332
33. Lindqvist, J., Jekunen, A., Sihvo, E., Johansson, M., & Andersén, H. (2022). Effect of adherence to treatment guidelines on overall survival in elderly non-small-cell lung cancer patients. Lung cancer (Amsterdam, Netherlands), 171, 9–17. https://doi.org/10.1016/j.lungcan.2022.07.006
34. Loğoğlu, A., Ayrik, C., Köse, A., Bozkurt, S., Demir, F., Narcı, H. ve Karaaslan, U. (2013). Examination of the Demographic Characteristics of Non-Traumatic Geriatric Cases Applying to the Emergency Department. Turkish J Emerg Med, 13 (4), 171-179. https://doi:10.5505/1304.7361.2013.82474 https://link.gale.com/apps/doc/A364958940/HRCA?u=anon~cb02477b&sid=googleScholar&xid=6a1898b1
35. Mukama, T., Fallah, M., Brenner, H., Xu, X., Sundquist, K., Sundquist, J., & Kharazmi, E. (2020). Risk of invasive breast cancer in relatives of patients with breast carcinoma in situ: a prospective cohort study. BMC medicine, 18(1), 295. https://doi.org/10.1186/s12916-020-01772-x
36. National Cancer Institute (NCN). (2023). Age and cancer risk. Retrieved February 21, 2023, from https://www.cancer.gov/about-cancer/causes-prevention/risk/age#:~:text=For%20example%2C%20the%20median%20age,66%20years%20for%20prostate%20cancer
37. Paillaud, E., Hamaker, M. E., & Soubeyran, P. (2022). Advances in geriatric oncology: Exploring practical ways to optimize treatment in older patients with cancer. Cancers, 14(17), 4129. https://doi.org/10.3390/cancers14174129
38. Özbek Yazıcı, S., Kaya, E., Tekin, A., & Doğan, Ş. (2006). Adherence to treatment in the elderly. Turkish Geriatrics Journal, 9(3), 177-181.
39. Özdemir, O., Akyüz, A., & Doruk, H. (2016). Adherence to drug therapy in geriatric hypertensive patients. Bakırköy Medical Journal, 12(4), 195-201. https://doi.org/10.5350/BTDMJB201612404
40. Siegel, R. L., Miller, K. D., & Jemal, A. (2016). Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66(1), 7-30. https://doi.org/10.3322/caac.21332
41. Sood, N., Liu, Y., Lian, M., et al. (2022). Association of endocrine therapy initiation timeliness with adherence and continuation in low-income breast cancer patients. Journal of Clinical Oncology, 40(36), 3793-3804. https://doi.org/10.1200/JCO.22.00399
42. Surveillance, Epidemiology, and End Results (SEER) Program. (2023). SEER is an authoritative source for cancer statistics in the United States. Retrieved February 21, 2023, from https://seer.cancer.gov/
43. WebMD. (2023). The most common cancers in older adults. Retrieved February 21, 2023, from https://www.webmd.com/healthy-aging/the-most-common-cancers-in-older-adults
44. World Health Organization (WHO). (2023). Ageing. Retrieved February 21, 2023, from https://www.who.int/health-topics/ageing#tab=tab_1
45. Yang, X., Huang, J., Zhu, X., Shen, K., Zhu, J., & Chen, X. (2020). Compliance with multidisciplinary team recommendations and disease outcomes in early breast cancer patients: An analysis of 4501 consecutive patients. Breast (Edinburgh, Scotland), 52, 135–145. https://doi.org/10.1016/j.breast.2020.05.008