How does self-efficacy affect treatment adherence in patients with renal cancer?

Background

Renal cancer is the 6^th most common cancer in the UK. Survival rates for renal cancer have significantly improved since targeted therapies were introduced in the 2000s. Adherence is critical for optimal clinical outcomes with these revolutionary treatments and, therefore, understanding the factors influencing adherence is essential. Changing behaviour has proven effective for enhancing patients’ self-efficacy, leading to better adherence to medication. Self-efficacy – an individual’s belief in their ability to perform specific tasks – remains understudied in this group.

Objectives

This study aimed to investigate the level of self-efficacy associated with renal cancer patients taking oral targeted therapies.

Method

A quantitative, electronic questionnaire survey was developed by a research team including a final year pharmacy student and incorporated elements of the validated General Self-Efficacy Scale (GSE). This study required and received ethics approval.

Participants included adults with advanced renal cancer taking oral targeted therapy who were recruited via social media channels of renal cancer support groups.The questionnaire comprised 21 questions covering demographics, self-efficacy, potential influencing factors on self-efficacy, and disease and treatment information. The primary outcome was self-efficacy scores. The maximum score was 50 with over 40 categorised as good. Self-efficacy was measured using Likert scales for 10 questions with statements ranked between 1 to 5. Secondary outcomes included factors associated with self-efficacy and adherence.

Descriptives statistics were used for continuous and categorical data and factors associated with self-efficacy scores were investigated by independent t-tests and univariate regression.

Results

From 80 respondents, 59 (73.8%) completed the entire self-efficacy questionnaire. The most common age group was 50 to 64 (n=27; 45.8%) with gender split as 24 (40.7%) males and 32 (54.2%) females (three participants did not specify gender). The majority identified as ‘white British’ (n=53; 89.8%).

The mean total self-efficacy score was 40.7±6.2, indicating generally high self-efficacy. The lowest median self-efficacy score was for maintaining healthy habits (3.5±1.1), managing side-effects (3.7±1.0) and adapting to treatment-related changes in life (3.8±0.9).

“Support groups” were the most utilised source of information (61.5%). Regarding emotional well-being, 7% described themselves as “very positive and optimistic”, whilst 73.7% were “generally positive, with occasional concerns”. There was no significant difference in total self-efficacy score across demographic and socioeconomic factors (p>0.05).

Conclusions

Patients with renal cancer involved with support groups generally exhibited good self-efficacy in managing their condition and adhering to targeted therapy. However, lower self-efficacy was noted in side-effect management, maintaining healthy habits, and adapting to treatment-induced changes. Limitations included recruiting from a support group where patients tend to be more motivated and therefore not generalisable beyond the patient group. Developing targeted interventions to address these challenges and enhance self-efficacy is crucial for improving patient outcomes in renal cancer.

 Additional authors: Wan-Chuen Liao^,, Jane Conley, Li-Chia Chen

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