This is a cross-sectional study conducted from May to September 2020. In total, 296 NSCLC patients undergoing targeted EGFR-TKI
therapy were recruited from hospitals in Henan, China. Structured questionnaires were used to evaluate skin
adverse drug reactions and medication literacy. Pearson correlation analysis and binary logistic regression analysis were carried out to identify the correlations between medication literacy and the severity of skin
adverse drug reactions in the recruited patients.
RESULTS: The research sample consisted of 296 patients with a response rate of 92.5%. The mean score of skin
adverse drug reactions and the mean score of medication literacy were 1.83 ± 0.91 and 6.54 ± 2.78, respectively. In total, 188 patients (63.5%) were considered to have moderate medication literacy. According to the binary logistic regression analysis, the following factors were associated with severe skin
adverse drug reactions: age (B = - 3.929, P = 0.000), sex (B = -4.062, P = 0.000), educational level (B = 2.712, P = 0.002), comorbidity (B = 3.297, P = 0.001),
eczema history (B = 2.996, P = 0.001), nutritional status (B = -4.891, P = 0.000), blood
interleukin-6 level (B = -2.143, P = 0.013), blood
high-sensitivity C-reactive protein level (B = -4.015, P = 0.000), combination of drugs (B = -3.183, P = 0.048) and medication literacy (B = - 1.503, P = 0.000). Subgroup analysis showed that in addition to medication literacy, some other factors including education level, comorbidity, nutritional status, blood
interleukin-6 level and combined drug application were common factors that contributed to various adverse skin drug reactions in NSCLC patients under targeted EGFR-TKI
therapy.
CONCLUSION: The low medication literacy of the investigated NSCLC patients undergoing targeted EGFR-TKI
therapy was correlated with a high proportion of severe skin
adverse drug reactions. In addition, factors other than medication literacy including education level, comorbidity, nutritional status, blood
interleukin-6 level and the combinatorial application of drugs were also related to the severity of various adverse skin drug reactions. A comprehensive and targeted intervention may be beneficial to improve medication literacy and control severe skin
adverse drug reactions in NSCLC patients.