Patient Engagement and Radiotherapy Adherence in Low-middle Income Countries: A Narrative Review

Abstract

Introduction: As a cost-effective means of cancer control, radiotherapy forms a critical component of treatment for many cancers in low-middle income countries. However, its success largely depends on patient adherence. This review aimed to identify the major factors that affect radiotherapy adherence in these settings, and discuss possible means by which these may be addressed.

Methods: The Pubmed, Scopus, Web of Science, Cochrane Library, and BioMed Central databases were searched for articles pertaining to radiotherapy adherence in low-middle income countries, that were published within the last decade.

Results: Published data pertaining to radiotherapy adherence are largely lacking in these countries. However, the available data show that non-adherence has an adverse impact on cancer outcomes in these settings. Low radiotherapy capacity, inequitably distributed resources, access barriers, and financial constraints often disrupt adherence with planned radiotherapy schedules. Research pertaining to the major causes of non-adherence to radiotherapy in this setting indicates that they can be addressed by effective patient communication and engagement. Nevertheless, the potential of these basic approaches in improving outcomes remains largely underutilized.

Conclusions: Appropriate and timely policies for improving patient education and engagement may make a meaningful improvement in radiotherapy acceptance, and thereby cancer control, in these countries.