title: Adherence to oral anticancer chemotherapy: What influences patients' over or non-adherence? Analysis of the OCTO study through quantitative-qualitative methods.
abstract: BACKGROUND
  Numerous oral anticancer chemotherapies are available. Non-adherence or over-adherence to these chemotherapies can lead to lowered efficacy and increased risk of adverse events. The objective of this study was to identify patients' adherence profiles using a qualitative-quantitative method.
  
  
  METHODS
  A capecitabine treatment was initiated for 38 patients with advanced breast or colorectal cancer. At inclusion, information on patients' beliefs was reported using a questionnaire. Later, Information on patients' relation to treatment was obtained from a sub-group during an interview with a sociologist. Questionnaires were analyzed using Multiple Classification Analysis to cluster patients. Treatment adherence was evaluated by an electronic medication event monitoring systems (MEMS caps) and then correlated with patient clusters. Interviews were analyzed to complete and explain results.
  
  
  RESULTS
  38 patients were enrolled between 2008 and 2011 and completed the questionnaire. Twenty had adherence measured with MEMS caps all along treatment. Between 4 and 6 months after inclusion, 16 patients were interviewed. Patient profile B (retired, with a regular life, surrounded by a relative's attention to drug adherence, with a low educational level) was statistically associated with adequate adherence (p = 0.049). A tendency for lower adherence was observed among more highly educated patients with an irregular, active life (NS). All patients taking capecitabine demonstrated a risk of over-adherence, potentiating side effects.
  
  
  CONCLUSIONS
  These encouraging primary results suggest that further studies should be undertaken and that educational programs tailored to patient profiles should be evaluated to enhance adherence for those who need it and to empower all patients to manage treatment side effects.
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. aurelie.bourmaud@icloire.fr.|Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institut, Inserm, CIC1408, 108 bis avenue A. Raimond, 42 270, Saint Priest en Jarez, France. aurelie.bourmaud@icloire.fr.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Bourmaud
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. emilie.henin@univ-lyon1.fr.
authors.forename: Emilie
authors.initials: E
authors.lastname: Henin
authors.affiliation: Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institut, Inserm, CIC1408, 108 bis avenue A. Raimond, 42 270, Saint Priest en Jarez, France. Fabien.tinquaut@icloire.fr.
authors.forename: Fabien
authors.initials: F
authors.lastname: Tinquaut
authors.affiliation: Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institut, Inserm, CIC1408, 108 bis avenue A. Raimond, 42 270, Saint Priest en Jarez, France. Veronique.regnier@icloire.fr.
authors.forename: Véronique
authors.initials: V
authors.lastname: Regnier
authors.affiliation: Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institut, Inserm, CIC1408, 108 bis avenue A. Raimond, 42 270, Saint Priest en Jarez, France. chloe.hamant@free.fr.
authors.forename: Chloé
authors.initials: C
authors.lastname: Hamant
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. olivier.colomban@univ-lyon1.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Colomban
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. benoit.you@chu-lyon.fr.|Medical Oncology Department, Teaching Hospital, Lyon-Sud University, Lyon, France. benoit.you@chu-lyon.fr.
authors.forename: Benoit
authors.initials: B
authors.lastname: You
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. florence.ranchon@chu-lyon.fr.|Oncologic Pharmaceutical Department, Lyon-Sud University Teaching Hospital, Lyon, France. florence.ranchon@chu-lyon.fr.
authors.forename: Florence
authors.initials: F
authors.lastname: Ranchon
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. jerome.guitton@chu-lyon.fr.|Pharmacology-Toxicology Laboratory, Hospices Civils de Lyon, South Biology Center, Lyon, France. jerome.guitton@chu-lyon.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Guitton
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. pascal.girard@merckgroup.com.
authors.forename: Pascal
authors.initials: P
authors.lastname: Girard
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. gilles.freyer@chu-lyon.fr.|Medical Oncology Department, Teaching Hospital, Lyon-Sud University, Lyon, France. gilles.freyer@chu-lyon.fr.
authors.forename: Gilles
authors.initials: G
authors.lastname: Freyer
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. Michel.tod@chu-lyon.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Tod
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. catherine.rioufol@chu-lyon.fr.|Oncologic Pharmaceutical Department, Lyon-Sud University Teaching Hospital, Lyon, France. catherine.rioufol@chu-lyon.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Rioufol
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. veronique.trillet-lenoir@chu-lyon.fr.|Medical Oncology Department, Teaching Hospital, Lyon-Sud University, Lyon, France. veronique.trillet-lenoir@chu-lyon.fr.
authors.forename: Véronique
authors.initials: V
authors.lastname: Trillet-Lenoir
authors.affiliation: EMR3738, Therapeutic Targeting in Oncology, Claude Bernard University, Lyon, France. Franck.chauvin@icloire.fr.|Public Health Department, Hygée Centre, Lucien Neuwirth Cancer Institut, Inserm, CIC1408, 108 bis avenue A. Raimond, 42 270, Saint Priest en Jarez, France. Franck.chauvin@icloire.fr.|Jean Monnet University, Saint-Etienne, France. Franck.chauvin@icloire.fr.
authors.forename: Franck
authors.initials: F
authors.lastname: Chauvin
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy*; D000069287:Capecitabine / Q000008:administration & dosage* / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D036301:Qualitative Research
chemical_list: D000964:Antimetabolites, Antineoplastic; D000069287:Capecitabine