title: Adherence with oral oncologic treatment in cancer patients: interest of an adherence score of all dosing errors.
abstract: OBJECTIVE
  Patient nonadherence to oral antineoplastic therapy is a well-recognized barrier to effective treatment. In order to identify patients who may need additional support to become adherent, it is important to have a useful tool that takes into account all the parameters of adherence to prescription. The aim of this prospective study was to evaluate adherence of oral antineoplastic agents and to investigate two calculation methods of adherence score.
  
  
  METHODS
  Twenty-nine cancer patients were enrolled in this study. Fourteen were treated by capecitabine and 15 patients by aromatase inhibitors. Adherence was measured using a medication event monitoring system and adherence score was calculated by a usual method and a composite adherence score that takes into account missed doses and also intake interval errors (between 2 doses and between meals).
  
  
  RESULTS
  Across the 6-month evaluation period, average adherence was 95% with the standard calculation (capecitabine group: 89%; aromatase inhibitor group: 99%) versus 83% with the composite index (capecitabine group: 62%; aromatase inhibitor group: 99%) (p = 0.030). The composite calculation permits to highlight more nonadherent patients (29.6 vs. 7.4%), particularly in the capecitabine group (73 vs. 18%, p = 0.001). We report 2 cases identified as nonadherent with composite adherence rate.
  
  
  CONCLUSIONS
  The composite adherence score permits to better evaluate adherence to prescription and to identify barriers to adherence and persistence.
authors.affiliation: Division of Clinical Research, Centre Jean Perrin, Clermont-Ferrand, France.
authors.forename: E
authors.initials: E
authors.lastname: Thivat
authors.forename: I
authors.initials: I
authors.lastname: Van Praagh
authors.forename: A
authors.initials: A
authors.lastname: Belliere
authors.forename: M A
authors.initials: MA
authors.lastname: Mouret-Reynier
authors.forename: F
authors.initials: F
authors.lastname: Kwiatkowski
authors.forename: X
authors.initials: X
authors.lastname: Durando
authors.forename: H
authors.initials: H
authors.lastname: Mahammedi
authors.forename: A F
authors.initials: AF
authors.lastname: Dillies
authors.forename: P
authors.initials: P
authors.lastname: Chollet
authors.forename: R
authors.initials: R
authors.lastname: Chevrier
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D047072:Aromatase Inhibitors / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy*; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D000077341:Lapatinib; D008297:Male; D055118:Medication Adherence; D008508:Medication Errors; D008875:Middle Aged; D010349:Patient Compliance; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D011799:Quinazolines / Q000008:administration & dosage
chemical_list: D047072:Aromatase Inhibitors; D011799:Quinazolines; D000077341:Lapatinib; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil