Abstract A75: Understanding Baseline Cancer Medication Adherence and Health Literacy among Cancer Patients in Eastern North Carolina
Authors: Torres Essie , Richman Alice , O'Rorke Shawna , Field Paige , Carlston Lauren 
Published: March 2017

Abstract
Background: Oral chemotherapeutic agents (OCAs) are often prescribed to cancer patients during treatment to reduce tumor size, burden of disease, and increase overall survival. Although OCAs are increasingly being used and are commonly preferred by patients, adherence varies with compliance rates as low as 16%. Poor medication adherence encompasses more than patients not taking their medicines as directed. The National Council on Patient Education provided a comprehensive overview of factors that contribute to poor adherence, which include medication-, patient-, prescriber-, pharmacy-related factors. Compounding these issues is low health literacy and transportation barriers that affect timely access to follow-up care which are prominent issues among rural populations. The main objective of this study is to conduct a baseline quantitative assessment to assess baseline medical adherence rates and health literacy among a sample of patients in a regional Cancer Center in Eastern North Carolina.
Methods: A baseline survey was created using already validated instruments (Morisky Medication Adherence Scale-8 (MMAS-8), Ask 12, and Realm-Revised). Demographic data includes gender, age, race or ethnicity, highest level of school completed, smart phone possession, type of health insurance, coverage for medication and annual household income. Eligibility criteria included adults over 18 years of age, English-speaking, and currently taking at least one medication in pill-form daily. Surveys were administered to patients in the waiting area in a regional Cancer Center in Eastern North Carolina from March-June 2016. A total of 75 patients completed the baseline survey.
Results: Over half of our sample were female (53%), 84% were cancer patients, 49% were African-American and 47% were white, and had a mean age of 59 (SD=13.44). The majority of our sample had a high school education or less (68%), 56% had Medicare/Medicaid, and 72% had an income of less than $40,000 a year. In regards to health literacy, 55% of participants were at risk for poor health literacy. The health literacy is approximately at a fourth grade level or below, and so patients may not be able to read prescription labels, may not be able to read most low-literacy materials; will need repeated oral instructions, materials composed primarily of illustrations, or audio or video tapes. For medication adherence, just over a quarter of our sample fell into the low adherent group (25%), 39% were medium adherent, and a third were highly adherent (32%). This means that the greater majority (64%) fell into the low or medium adherent categories.
Conclusion: This study shows that the majority of ENC cancer patients are at risk for poor literacy and have medium to low medication adherence. The next phase of this study will test two telehealth adherence strategies among cancer patients taking OCAs who are at high-risk for non-adherence. We will include multiple levels of education and different education strategies based on each patient's health literacy level and identified barriers to adherence.
Supported in part by a research grant from Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this abstract are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp.
Citation Format: Essie Torres, Alice Richman, Shawna O'Rorke, Paige Field, Lauren Carlston. Understanding Baseline Cancer Medication Adherence and Health Literacy among Cancer Patients in Eastern North Carolina. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A75.