title: Adherence management for patients with cancer taking capecitabine: a prospective two-arm cohort study.
abstract: OBJECTIVE
  To develop and evaluate a multiprofessional modular medication management to assure adherence to capecitabine.
  
  
  METHODS
  The study was conducted as a prospective, multicentred observational cohort study. All participants received pharmaceutical care consisting of oral and written information. Daily adherence was defined as percentage of days with correctly administered capecitabine doses and assessed using medication event monitoring. According to their daily adherence during the first cycle, patients were identified as initially non-adherent (<90% adherence) or adherent (≥90% adherence). Initially non-adherent patients received additional adherence support.
  
  
  RESULTS
  Seventy-three patients with various tumour entities were enrolled, 58 were initially adherent and 15 non-adherent. Median daily adherence of initially non-adherent patients increased from 85.7% to 97.6% during the observation period of six cycles. Throughout all cycles, median daily adherence of initially adherent patients was 100.0%. Daily adherence was not associated with sociodemographic and disease-related factors. No patient was non-persistent.
  
  
  CONCLUSIONS
  An early adherence screening effectively distinguishes between patients adhering and non-adhering to capecitabine. The provision of specific adherence support is associated with enhanced adherence of initially non-adherent patients, whereas initially adherent patients remain adherent for at least six cycles without specific support. Our needs-based approach helps to use available resources for adherence management efficiently.
authors.affiliation: Institute of Pharmacy, Clinical Pharmacy, University of Bonn, Bonn, Germany.
authors.forename: Linda
authors.initials: L
authors.lastname: Krolop
authors.forename: Yon-Dschun
authors.initials: YD
authors.lastname: Ko
authors.forename: Peter Florian
authors.initials: PF
authors.lastname: Schwindt
authors.forename: Claudia
authors.initials: C
authors.lastname: Schumacher
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jaehde