title: 'Tablet burden' in patients with metastatic breast cancer.
abstract: The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored.
  
  
  OBJECTIVE
  We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment.
  
  
  METHODS
  One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets.
  
  
  RESULTS
  The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience.
  
  
  CONCLUSIONS
  Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC.
authors.affiliation: St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK.
authors.forename: Marina
authors.initials: M
authors.lastname: Milic
authors.affiliation: St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Foster
authors.affiliation: St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK; Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy.
authors.forename: Karim
authors.initials: K
authors.lastname: Rihawi
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals Trust, Leeds, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Anthoney
authors.affiliation: Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals Trust, Leeds, UK. Electronic address: c.j.twelves@leeds.ac.uk.
authors.forename: Chris
authors.initials: C
authors.lastname: Twelves
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D015897:Comorbidity; D017281:Cost of Illness; D004334:Drug Administration Schedule; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D057240:Patient Preference; D019338:Polypharmacy; D011795:Surveys and Questionnaires; D013607:Tablets
chemical_list: D013607:Tablets
keywords: Breast cancer; Medication; Oral; Polypharmacy