Fear of Recurrence and Medication Adherence in Pediatric Leukaemia Survivors in Low-Resource Settings.
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OBJECTIVES: Childhood leukaemia patients who survived their treatment often experience Fear of Cancer Recurrence (FCR), which can affect Medication Adherence (MA), particularly in low-resource environments. This paper explored the relationship between FCR and adherence among pediatric survivors. MATERIALS AND METHODS: A cross-sectional study was conducted in tertiary care pediatric oncology clinics in low-resource settings, involving 444 children diagnosed with Acute Lymphoblastic Leukaemia (ALL) or Acute Myeloid Leukaemia (AML). The FCR was assessed using the validated Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF), and adherence was assessed using the validated Medication Adherence Rating Scale (MARS-10). The statistical tests were correlation test, independent t-tests, one-way ANOVA, and multiple linear regression. RESULTS: The average FCRI-SF score was 27.0 +/- 2.6, and the average MARS-10 score was 15.1 +/-1.1. Medication adherence was significantly negatively associated with fear of cancer recurrence (r = -0.210, p < 0.001). Women had higher FCRI-SF (27.4 ± 2.9) than men (26.5 ± 2.4), and lower MARS-10 scores (14.8 ± 1.1 vs. 15.4 ± 1.0). The highest FCR (27.8 ± 2.4) and the lowest adherence (14.7 ± 1.0) were found in adolescents (15-17 years). Regression analysis revealed that FCR (B = -0.15, p = 0.001), female gender (B = -0.40, p = 0.001), treatment phase (B = -0.09, p = 0.003), and missed chemotherapy cycles (B = -0.07, p = 0.001) were significant predictors of poor adherence. CONCLUSION: FCR is a significant psychological risk factor of medication adherence in survivors of paediatric leukaemia. Psychosocial support and follow-up strengthening can be used to decrease non-adherence and treatment abandonment.