Assessing adherence to oral chemotherapy using different measurement methods: Lessons learned from capecitabine
- 9 September 2013
- journal article
- research article
- Published by SAGE Publications in Journal of Oncology Pharmacy Practice
- Vol. 20 (4), 249-256
- https://doi.org/10.1177/1078155213501100
Abstract
Purpose Adherence to oral medication is important in oncology. Few studies have evaluated adherence with cancer agents such as capecitabine, which is given on a complicated schedule. Furthermore, little guidance exists regarding the best methods for monitoring adherence with oral cancer drugs. The purpose of our study was to evaluate adherence to capecitabine using several accepted measures. Patients and methods Patients treated with capecitabine for gastrointestinal cancers were included in this prospective cohort study. Adherence was evaluated during two consecutive cycles of capecitabine using three assessment methods: self-report, pill count, and use of a microelectronic monitoring system. The primary endpoint was proportion of patients adherent to capecitabine (>80% of adherence according to the three methods of measurement); the secondary objective was to compare the three methods of measurement. Results Nineteen patients were accrued to this study. Further accrual was stopped after the first planned analysis, because 18 and 19 patients were adherent by self-report and pill count, respectively. The overall adherence rates were 99, 100, and 61% with self-report, pill count, and microelectronic monitoring system cap, respectively. Ten (53%) patients were classified as nonadherent (<80% of adherence according to at least one method of measurement), but four of them transferred their pills into another medication container suggesting that measurement of adherence using microelectronic monitoring system technology may not be useful. Conclusion While we did not identify a major adherence issue with capecitabine in our study, it provides insight into problems associated with measurement of adherence in oncology and suggests that combining measures of adherence maximizes accuracy.Keywords
This publication has 24 references indexed in Scilit:
- One vs Three Years of Adjuvant Imatinib for Operable Gastrointestinal Stromal TumorJAMA, 2012
- Poor adherence is the main reason for loss of CCyR and imatinib failure for chronic myeloid leukemia patients on long-term therapyBlood, 2011
- Adherence and Persistence With Oral Adjuvant Chemotherapy in Older Women With Early-Stage Breast Cancer in CALGB 49907: Adherence Companion Study 60104Journal of Clinical Oncology, 2010
- Adherence Is the Critical Factor for Achieving Molecular Responses in Patients With Chronic Myeloid Leukemia Who Achieve Complete Cytogenetic Responses on ImatinibJournal of Clinical Oncology, 2010
- Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trialThe Lancet, 2009
- Patient adherence and persistence with oral anticancer treatmentCA: A Cancer Journal for Clinicians, 2009
- Adherence to MedicationThe New England Journal of Medicine, 2005
- Patient preferences for oral versus intravenous palliative chemotherapy.Journal of Clinical Oncology, 1997
- Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring.Journal of Clinical Oncology, 1993
- Prospects for Antiestrogen Chemoprevention of Breast CancerJNCI Journal of the National Cancer Institute, 1990