The impact of social determinants of health on primary adherence to oral oncolytic medications

Abstract

Introduction

Oral oncolytic medications have transformed cancer treatment, yet adherence to these therapies remains a significant challenge. This study aims to investigate the impact of social determinants of health (SDOH)—including access to basic necessities, health literacy, and social support— on primary adherence to oral oncolytic medications within a specialty pharmacy population of a large quaternary academic medical center.

Methods

This retrospective study assessed patient characteristics and medication adherence data taken from patients’ electronic health records, as well as SDOH barriers from a self-reported patient questionnaire. Using multivariable logistic regression, the presence of SDOH barriers and their impact on oral oncolytic adherence were assessed.

Results

When assessing the association between patient characteristics and the presence of any SDOH barriers, patients who had a non-English primary language had 25.9 higher odds of reporting an SDOH barrier compared to patients whose primary language was English (95% CI: 3.6 to 579, p = 0.007). When assessing associations between individual SDOH categories and oral oncolytic primary adherence rate, patients who identified no health literacy barriers had 2.14 higher odds of filling their prescribed oral oncolytic medication(s) compared to patients who did identify barriers in health literacy (95% CI: 1.02 to 4.52, p = 0.044).

Conclusion

This study highlights the impact of social determinants of health on medication adherence in a specialty pharmacy population, especially in relation to language and health literacy. The results may inform healthcare providers and policymakers in developing comprehensive support systems to optimize medication adherence for patients receiving oral oncolytic therapies.