What is it about?

Understanding why and when cancer patients may miss, avoid or discontinue their treatment is a complex multi-factorial phenomenon. This article takes a qualitative approach to examining Author findings found in Cancer Patient Surveys and reports into medication and /or treatment nonadherence. The period referred to dates back to 2003 when the World Health Organisation (WHO) first published a mult-dimensional definition of treatment adherence. The focus of this article is the possible influence of Physician - Patient relationships on cancer patient treatment adherence/nonadherence (i.e., information, communication, concordance). How treatment or medication adherence is defined and the differing priorities of patients and physicians during the disease trajectory is explored.

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Why is it important?

Treatment nonadherence in cancer remains high. Few interventions to reduce treatment nonadherence in cancer patients have been successful or succeed beyond pilot studies or on a large scale. Of particular importance in this review are: (i) The descriptive summaries of key differences that help define both intentional and unintentional treatment nonadherence for future framework development of interventions; (ii) The need to consider Physican factors, as these are not highlighted or shown as a separately identified dimension in the original WHO multi-dimensional overview of treatment adherence (WHO,2003). This scoping review suggests that Physician factors (in terms of the possible influence of Physician/Patient relationships in treatment nonadherence) is understated and hardly represented in the literature.


The personal rewards from performing this research were during synthesis of data as knowledge gaps became clearer and understated concepts evolved. Myself and co authors particularly appreciate the invaluable feedback received from PLOS ONE reviewers during the peer-review process. This resulted in a series of improvements in presentation and the inclusion of missing details to provide greater clarity to the methodology. In this study, findings from qualitative and *quantitative data (qualitative author discussions and conclusions) were synthesised using the principles of meta-ethnograpy to enable these new insights and a line of argument. This mixed qualitative approach applied is not widely used but seemed an appropriate solution to addressing the research question. The choice of methodology was due to a preponderance of studies relating to the topic being quantitative, but lacking rich qualitative explanation. We now look forward to completing method triangulation in order to validate or refute findings. Meanwhile, I hope readers may derive some benefit from reading the study - both from an academic point of view and in consideration of interest from Health Professionals.

Leon Wreyford
University of Southern Queensland

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This page is a summary of: When can cancer patient treatment nonadherence be considered intentional or unintentional? A scoping review, PLoS ONE, May 2023, PLOS, DOI: 10.1371/journal.pone.0282180.
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