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Surviving Lung Cancer: Medication-Taking and Oral Targeted Therapy

Wickersham, Karen E. (2012) Surviving Lung Cancer: Medication-Taking and Oral Targeted Therapy. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors increase survival and improve quality of life for patients with non-small cell lung cancer (NSCLC). Because oral EGFR inhibitors are a new therapy, the implications for medication-taking are unknown. We used grounded theory to explore the process of medication-taking for patients with NSCLC who were receiving therapy with oral EGFR inhibitors. We sought to describe the medication-taking process and to identify factors influencing medication-taking. We enrolled men and women from a National Cancer Institute-designated cancer center aged 18 years or older with NSCLC receiving oral EGFR inhibitors who were able to speak, read, and understand English. Exclusion criteria included central nervous system metastases and evidence of cognitive impairment as assessed by the Mini-Mental Status Exam. Thirteen participants were purposively selected for variation in gender (5 men/8 women), race/ethnicity (2 non-whites), age (52-83 years), time in therapy (1 week to 6 or more years), dose reductions (n = 5), and therapy discontinuation (n = 2). Theoretical sampling focused on age and health insurance carrier. Data were collected through 32 semiformal and brief interviews concerning one’s medication-taking behaviors related to therapy with oral EGFR inhibitors. We employed constant comparative and dimensional analyses. The basic psychosocial process, Surviving Lung Cancer, which participants framed within the recognition of NSCLC as a life-limiting illness without cure, included a dynamic process of (a) Deciding to take targeted therapy with erlotinib, (b) Preparing for erlotinib, and (c) Treating lung cancer as a chronic condition. Participants described thresholds that may result in stopping erlotinib, including side effects and cost. Men described taking erlotinib therapy in partnership with their spouse; most women managed erlotinib alone. These findings may provide the theoretical basis for developing patient-centered interventions to address medication-taking.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Wickersham, Karen E.kew44@pitt.eduKEW44
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairErlen, Judith A.jae001@pitt.eduJAE001
Committee MemberHapp, Mary
Committee MemberBender, Catherine M.cbe100@pitt.eduCBE100
Committee MemberEngberg, Sandra J.sje1@pitt.eduSJE1
Committee MemberTarhini, Ahmad Alitarhiniaa@upmc.eduAAT8
Date: 3 October 2012
Date Type: Publication
Defense Date: 21 September 2012
Approval Date: 3 October 2012
Submission Date: 25 September 2012
Access Restriction: 1 year -- Restrict access to University of Pittsburgh for a period of 1 year.
Number of Pages: 216
Institution: University of Pittsburgh
Schools and Programs: School of Nursing > Nursing
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Medication-taking; grounded theory; targeted therapy; cancer survivorship; non-small cell lung cancer
Date Deposited: 03 Oct 2012 15:58
Last Modified: 07 Mar 2017 17:10


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