Cross-sectional survey of factors influencing treatment adherence in elderly cancer patients in rural mountainous Guangyuan, China

Figure 1 Of 130 eligible participants initially assessed, 5 refused participation, and 125 provided informed consent. A total of 103 participants completed the core scales [Comprehensive Score for Financial Toxicity (COST), Supportive Care Needs Survey-Short Form 34 (SCNS-SF34), and 8item Morisky Medication Adherence Scale (MMAS-8)] and constituted the final core analysis sample; the remaining 22 did not complete these scales for various reasons. Within this core sample, instrument-specific completion rates varied: SCNS-SF34 was completed by 106 participants (including 3 who did not complete COST), COST by 103, MMAS-8 by 102 (1 missing), PRO-CTCAE by 71-81 depending on the symptom, and Hospital Anxiety and Depression Scale/Distress Thermometer/Social Support Rating Scale by 49 participants. Analyses of psychological status (Hospital Anxiety and Depression Scale/Distress Thermometer/Social Support Rating Scale) were exploratory and limited to these 49 participants. Note: Sample sizes differ across additional instruments due to variable completion rates. SCNS-SF34 and COST were the core predictor scales; MMAS-8 was the primary outcome. COST: Comprehensive Score for Financial Toxicity; SCNS-SF34: Supportive Care Needs Survey-Short Form 34; MMAS-8: 8-item Morisky Medication Adherence Scale; PRO-CTCAE: Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events; DT: Distress Thermometer; HADS: Hospital Anxiety and Depression Scale; SSRS: Social Support Rating Scale.