Butow and colleagues presented a broad overview of the issues and clinical challenges of nonadherence in adolescents and young adults (AYAs) with cancer. Nonadherence can reduce treatment efficacy, which places the patient at higher risk of relapse, adverse effects, and poor outcomes. A review of the English-speaking literature between 1980 and 2008 was conducted to identify relevant publications, which were supplemented by reference and author searches. Definition and measurement of adherence varies. Most studies have not clearly delineated an AYA age group (i.e., 15-25 years) and have been dominated by leukemia and lymphoma samples. Estimates for nonadherence in this population range from 27% to 60%, with openness of family relationships and support found to predict adherence. Strategies to avoid, assess, and manage nonadherence are presented.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that overall, the evidence base for adherence and strategies to promote it in AYAs with cancer is woefully lacking. There is a need for high-quality studies that target clinically important questions, randomized controlled trials of theoretically based interventions, and development and evaluation of training programs for oncology staff in the special issues faced by AYAs with cancer.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The study makes a cogent argument for the development of self-management programs for young adults with cancer.

J Butow et al. Review of Adherence-Related Issues in Adolescents and Young Adults With Cancer. Journal of Clinical Oncology, March 8, 2010.