Factors influencing adherence to intravesical instillation therapies for non-muscle-invasive bladder cancer: a scoping review protocol

INTRODUCTION: Non-muscle-invasive bladder cancer is often treated with repeated weekly intravesical instillations of chemotherapy or immunotherapy. The number of instillations received influences the risk of recurrence and progression; thus, treatment completion is crucial. However, previous research indicates that nearly half of patients do not adhere to treatment for various reasons. This scoping review aims to define the concept of treatment adherence to intravesical instillation therapies and identify and map the factors that influence treatment adherence in intravesical instillation therapies. METHODS AND ANALYSIS: This scoping review will adhere to the Joanna Briggs Institute's Manual for Evidence Synthesis and will be reported in accordance with the PRISMA Extension for Scoping Reviews. A comprehensive search strategy will be employed to guide the literature search across databases, including MEDLINE, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Central Register of Controlled Trials.We will include studies on intravesical instillation therapies with BCG or Mitomycin C for non-muscle-invasive bladder cancer, as well as studies that describe factors influencing patients' adherence to treatment. Screening of abstracts and full texts, as well as data charting, will be performed independently by two researchers using the Covidence software. We will collect and chart data concerning characteristics of the source and setting, treatment specifics, reasons for non-adherence and any factors that affect adherence.We will summarise each included source and present the identified factors in a narrative synthesis. Furthermore, we will describe how the results inform the review objective. ETHICS AND DISSEMINATION: Ethical approval is not required for this scoping review, as all data have been published. The findings of the scoping review will be disseminated in a scientific publication and widely presented to researchers, healthcare professionals and patients.