BackgroundNumerous 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.MethodsA 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.Results38 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.ConclusionsThese 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1231-8) contains supplementary material, which is available to authorized users.
Cet article présente les résultats d'une enquête concernant l'éthique de la prévention. Elle a été réalisée au sein d'une recherche interventionnelle en santé des populations, mobilisant des médiateurs (navigateurs) pour corriger les inégalités de participation au dépistage organisé du cancer colorectal dans 5 départements français. Quatre tensions éthiques émergent sur le terrain : à propos de l'incertitude du test, de l'organisation des campagnes, de l'intrusion dans la vie privée et de l'universalisme proportionné. Ces tensions sont décrites à partir d'une enquête ancrée dans une approche pragmatiste, attentive aux épreuves que vivent les acteurs de la prévention, intégrant dans un même mouvement l'investigation sur les faits et la réflexion sur les valeurs.
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