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Psychometric properties of instruments for assessing adherence to oral antineoplastic agents: a COSMIN systematic

Miaomiao Sun1, Kanghui Huang1, Suxiang Liu1

  • 1Department of Nursing, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.

Peerj
|March 17, 2025
PubMed
Abstract

Insights

Selecting the right tool to track oral antineoplastic agent (OAA) adherence in cancer patients is vital. This review found that current OAA adherence instruments have limited psychometric properties and require further validation for reliable cancer patient monitoring.

Area of Science:

  • Oncology
  • Pharmacology
  • Health Measurement

Background:

  • Oral antineoplastic agents (OAAs) are increasingly used for cancer treatment.
  • Accurate assessment of patient adherence to OAAs is critical for treatment efficacy.
  • Existing instruments for measuring OAA adherence require rigorous evaluation of their psychometric properties.

Purpose of the Study:

  • To identify and evaluate the psychometric properties of instruments used for assessing adherence to oral antineoplastic agents (OAAs) in cancer patients.
  • To provide guidance on selecting appropriate measurement tools for OAA adherence.

Main Methods:

  • Systematic literature search of eight electronic databases (PubMed, Embase, Web of Science, CINAHL, CNKI, Wanfang, Weipu, Sinomed) until December 31, 2023.
  • Adherence to Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Inclusion of eight studies evaluating eight distinct instruments for OAA adherence.

Main Results:

  • Eight instruments were identified, with four applicable to any OAA and four specific to certain OAAs.
  • None of the evaluated instruments fully met COSMIN criteria, with significant limitations in measurement error, cross-cultural validity, and responsiveness.
  • Seven instruments received a weak recommendation for OAA adherence assessment; one was not recommended due to poor internal consistency.

Conclusions:

  • Current instruments for assessing OAA adherence in cancer patients exhibit limited reliability and validity.
  • Further rigorous validation of existing instruments is essential.
  • Development of new instruments with robust measurement properties is urgently needed for accurate OAA adherence assessment.
Keywords:
CancerMedication adherenceOral antineoplastic agentsPatient-reported outcome measuresPsychometric properties

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