Adherence with capecitabine: A population-based analysis based on prescription refill data

Abstract

Background Patient adherence is important with the increasing use of oral anticancer drugs. Recent studies reported different capecitabine adherence rates based on self-reporting and microelectronic monitoring of the medication bottle. Patient's awareness of being monitored may confound these results. Prescription records provide a larger and more objective dataset for adherence investigation. We report the use of computer algorithm and manual review of prescription and medical documentation to determine the rate of capecitabine adherence. Methods Two years of capecitabine prescription records from five ambulatory cancer centres were reviewed. Prescription data were extracted using a custom Java-based software tool to compare the predicted vs. actual dispensing date. The difference between the dates was the primary adherence measure (altered treatment date incident) and estimated using a computer algorithm and by manual review of medical charts. Results Of 4412 refill prescriptions, 45.2% was associated with an altered treatment date incident based on the initial computer algorithm. This was reduced to 29.5% after adjusting for clinic scheduling processes and 10.2% after manual chart review to adjust for valid reasons for delay. The reasons for altered treatment date incident were not identified in 52.2% of prescriptions. Conclusions Adherence rate of capecitabine based on refill data seem to be high and consistent with other findings based on patient self-report. Population analysis of prescription data with custom computer algorithm may identify trends in capecitabine adherence with some efficiency. Manual review would likely be required to verify these results. The accuracy of using altered prescription refill dates as an adherence measure requires further studies.

Real-life adherence in capecitabine therapy using two analysis methods and persistence after 6 months of treatment

“…20,21 Depending on the methods used to calculate adherence, previous studies reported compliance rates for capecitabine therapy ranging from 67.9% to 98%. 22,23 There are several ways to measure adherence levels, including self-reporting (SR), tests like the Morisky Medication Adherence Scale (MMAS-8) and the Haynes and Sackett method, 24 the therapy diary, 25 pharmacy-refill methods, 26 metabolite titration in blood or urine samples. 27,28 The latter are often considered the gold standard for adherence calculation 29,30 although, much like blood tests, they are expensive, impractical and difficult to implement.…”

Oral Antikanser İlaç Kulanan Kanser Hastalarında Telefon ile Yapılan İzlemin İlaç Uyumuna Etkisi: Sistematik Derleme

“…Orak antikanser ilaçları kanser tedavisinin %25'ini oluşturmaktadır 1,2 .Oral kemoterapi ilaç kullanımı; hastalara tedavi yönetimlerinin kendi ellerinde olması, ev ortamlarında tedavi olabilmeleri, seyahat özgürlükleri, intravenöz tedavi komplikasyonlarının önlenmesi gibi pek çok avantajlar sağlamaktadır. Ancak hastaların evde bu ilaçları yeterince destek almadan kullanmalarına bağlı, yan etki yönetiminde başarısızlık, ilaç almayı unutma, ilaç alma saatlerinde uyumsuzluk, kür programını yanlış uygulama gibi ilaç uyumsuzluğuna bağlı dezavantajları da beraberinde getirmektedir [3][4][5][6][7][8][9] . Oral kemoterapi kullanımı ile onkoloji hemşiresi için tedavi uygulama yükü, evde tedaviye uyumun değerlendirilmesi, izlemi ve yan etki yönetimi değişmiştir 10 .…”