Caregivers' perceptions of medical compliance in adolescents with cancer

Two studies were conducted to investigate the prevalence and determinants of gross medical regimen noncompliance among adolescent cancer patients. In the first study, 28 children and adolescents were rated by their primary physicians on various aspects of medical regimen compliance, features of their disease, and treatment regimens. Adolescent patients overall were judged to be significantly less compliant than the younger patients (p less than 0.001), with almost half rated as being "poor" or "very poor" compliers. Poor compliance was judged to be a potential threat to the prognoses of over half of the adolescents studied. Adolescents were reported to experience more severe side-effects and more visible physical residua as a result of their illness and treatment than the younger patients. The second study, conducted at a large pediatric referral center, found far fewer compliance problems among the 65 adolescent patients reviewed, with negative ramifications for treatment outcome reported in only nine patients (14%). The impact of medical variables, patient characteristics, and treatment setting on compliance with antineoplastic therapy is discussed. Issues in compliance assessment and considerations for future research are addressed. It is concluded that routine assessment of compliance is crucial for monitoring patient behavior as well as for the reliable evaluation of treatment protocols.