Objectives: While oral anticancer treatment has increased the convenience for patients with no risk of venous access complications compared to intravenous drug administration, a high level of compliance cannot always be assumed. The aim of the present report was to evaluate real-life drug adherence in a prospective cohort analysis of patients with gastrointestinal or breast cancer treated with capecitabine-based chemotherapy. Methods: Twenty-nine Swiss oncologists recruited patients receiving capecitabine, either as monotherapy or in combination with other chemotherapeutic agents, in a prospective fashion. Patients recorded both their capecitabine intake and any adverse effects each day in patient diaries. Results: A total of 177 patients were included, 143 (81%) with gastrointestinal tumours and 34 (19%) with breast cancer. Overall, 161 patients (91%) were considered as fully compliant, while 16 patients (9%) reported some kind of compliance error. Reasons for non-compliance included forgetting to take treatment (n = 9), side effects (n = 4) and misunderstanding instructions (n = 3). Self-reported compliance was not influenced by age or Eastern Cooperative Oncology Group performance status, but there was a trend towards better compliance with capecitabine therapy if fewer adverse effects occurred (p = 0.07, simple logistic regression). Conclusions: Self-reported compliance with capecitabine-based therapy in clinical practice is high and seems to be adversely affected by side effects.

Keywords:
Breast cancer, Capecitabine, Compliance, Gastrointestinal cancer
1.
O’Neill VJ, et al: Oral cancer treatment: developments in chemotherapy and beyond. Br J Cancer 2002;87:933–937.
2.
Ruddy K, et al: Patient adherence and persistence with oral anticancer treatment. CA Cancer J Clin 2009;59:56–66.
3.
Ziller V, et al: Adherence to adjuvant endocrine therapy in postmenopausal women with breast cancer. Ann Oncol 2009;20:431–436.
4.
Kruk ME, et al: The relation between intermittent dosing and adherence: preliminary insights. Clin Ther 2006;28:1989–1995.
5.
Midgley R, et al: Capecitabine: have we got the dose right? Nat Clin Pract Oncol 2009;6:17–24.
6.
Macintosh PW, et al: A comparison of patient adherence and preference of packaging method for oral anticancer agents using conventional pill bottles versus daily pill boxes. Eur J Cancer Care (Engl) 2007;16:380–386.
7.
Rough A, et al: Questionnaire audit assessing compliance in colon cancer patients taking adjuvant capecitabine (X) as part of the X-ACT trial (abstract 283P). Ann Oncol 2004;15(suppl 3):iii75.
8.
Cramer JA, et al: Medication compliance and persistence: terminology and definitions. Value Health 2008;11:44–47.
9.
Vander Stichele R: Measurement of patient compliance and the interpretation of randomized clinical trials. Eur J Clin Pharmacol 1991;41:27–35.
10.
Blum JL, et al: Multicenter phase II study of capecitabine in paclitaxel-refractory metastatic breast cancer. J Clin Oncol 1999;17:485–493.
11.
Jasti S, et al: Correction for errors in measuring adherence to prenatal multivitamin/mineral supplement use among low-income women. J Nutr 2006;136:479–483.
12.
Waterhouse DM, et al: Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring. J Clin Oncol 1993;11:1189–1197.
13.
Pullar T, et al: Time to stop counting the tablets? Clin Pharmacol Ther 1989;46:163–168.
14.
Partridge AH, et al: Adherence and persistence with oral adjuvant chemotherapy in older women with early-stage breast cancer in CALGB 49907: adherence companion study 60104. J Clin Oncol 2010;28:2418–2422.
15.
Barron TI, et al: Early discontinuation of tamoxifen: a lesson for oncologists. Cancer 2007;109:832–839.
16.
Smith A, et al: Compliance with drug treatment. Br Med J 1979;1:1335–1336.
17.
Tebbi CK, et al: Compliance of pediatric and adolescent cancer patients. Cancer 1986;58:1179–1184.
18.
Lancaster D, et al: Profile of non-compliance in lymphoblastic leukaemia. Arch Dis Child 1997;76:365–366.
19.
Lash TL, et al: Adherence to tamoxifen over the five-year course. Breast Cancer Res Treat 2006;99:215–220.
20.
Demissie S, et al: Adjuvant tamoxifen: predictors of use, side effects, and discontinuation in older women. J Clin Oncol 2001;19:322–328.
© 2011 S. Karger AG, Basel
2011
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.