Capecitabine non-adherence: exploration of magnitude, nature and contributing factors.
Capecitabine non-adherence: exploration of magnitude, nature and contributing factors.
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DOI：
10.1177/1078155211436022
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发表时间：
2012-09-01
期刊：
影响因子：
--
通讯作者：
Watson, Steven
中科院分区：
文献类型：
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作者：
Bhattacharya, Debi;Easthall, Claire;Watson, Steven
目的：口服化疗药物的处方以前只能在静脉制剂中使用，如卡培他滨，已经提供了许多好处，包括降低了管理成本和提高了患者的接受性。然而，它也带来了确保患者坚持治疗的新挑战。因此，有必要对服药依从性进行量化，以期改善服务，探索可能影响服药行为的因素。方法：从英国一家教学医院招募被诊断为乳腺癌或结直肠癌并服用卡培他滨的患者。记录有关自我报告的依从性、对药物的信念、副作用以及对收到的有关卡培他滨的信息的满意度。结果：43名参与者中有23.3%的人报告了不依从性。97.6%的人认为卡培他滨治疗是必要的，但近三分之一的参与者有强烈的担忧。80%的参与者报告了副作用，其中手掌足底红肿感觉和疲劳最困扰参与者。65%的参与者对收到的信息表示完全满意；然而，42.9%和37.3%的参与者对如何判断卡培他滨是否有效和建议的疗程表示不满意。结论：卡培他滨的依从性很高，并坚信治疗是必要的。然而，有人对副作用的体验表示关切。患者对有关监测卡培他滨疗效和确定疗程的过程的信息需求尚未得到满足。因此，医疗保健专业人员可能希望考虑更多地关注让患者参与监测他们的护理的有效性和计划的治疗时间表。
OBJECTIVES: The prescribing of oral chemotherapy agents previously available only in the intravenous formulation, such as capecitabine, has afforded many benefits including reduced administration costs and improved patient acceptability. However, it has introduced the new challenge of ensuring patient adherence to therapy. It is therefore necessary to quantify adherence, and with a view to improving services, explore factors that may impact on medication taking behavior.METHODS: Patients with a diagnosis of breast or colorectal cancer and prescribed capecitabine were recruited from a UK teaching hospital. Data regarding self-reported adherence, beliefs about medicines, side effects, and satisfaction with information received about capecitabine were recorded.RESULTS: Non-adherence was reported by 23.3% of the 43 participants. Capecitabine therapy was perceived necessary by 97.6%, but almost one-third of participants had strong concerns. Side effects were reported by 80% of participants, with Palmar-Plantar erythrodysesthesia and fatigue most troubling participants. Complete satisfaction with information received was reported by 65% of participants; however, dissatisfaction about how to tell if capecitabine is working and the proposed duration of therapy was expressed by 42.9% and 37.3% of participants, respectively.CONCLUSIONS: Adherence to capecitabine is high with a strong conviction that the therapy is necessary. However, concerns were expressed regarding the experience of side effects. Patients have unmet information needs regarding the processes involved with monitoring capecitabine efficacy and determination of therapy duration. Healthcare professionals may therefore wish to consider a greater focus on involving patients in the monitoring of their care with respect to efficacy and planned treatment schedules.