Adherence to oral anticancer drugs (OAD) in patients (pts) with metastatic renal cancer (mRCC): First results of the prospective observational multicenter IPSOC study (Investigating Patient Satisfaction with Oral Anti-cancer Treatment).

Abstract

4622 Background: Patient adherence to oral therapy is a critical issue in cancer treatment. The aim of this study is to investigate the prevalence and severity of non-adherence to OAD in mRCC and to identify factors predictive of non-adherence. Methods: Prospective observational multicenter trial performed at 11 Belgian academic and non-academic centers. All pts with mRCC starting OADs (sunitinib, pazopanib, everolimus or sorafenib) are eligible for the study. Pts are contacted by phone at baseline and at 1, 3, 6 and 12 months. At each contact, pts are asked to complete questionnaires investigating 1) medication adherence (MMAS), 2) patient satisfaction with treatment (CTSQ) and with treatment education (PS-CaTE), 3) the extent of information desire (EID), 4) quality of life (FACT-G and FKSI) and 5) the role of the pharmacist (SWiP). Adherence is measured using an electronic medication event monitoring system (MEMS, Aardex). Results: Between 02/2011 and 11/2011, 49 pts (m: 33, f: 16) with a median age of 63 years (range 25 - 87) have participated in the IPSOC study. Twenty-nine pts (64%) were treated with an OAD in first-line, 15 pts (33%) in second-line. With a median follow-up of 131 days (range 2 - 313) 45 pts (92%) claimed to be fully adherent to their treatment (based on MMAS and CTSQ data). Four patients indicated to have missed at least one dose, of whom two indicated they occasionally forgot their medication and two others interrupted treatment because of side effects. Based on MEMS data, mean adherence, defined as the percentage of days with at least the prescribed number of dosage taken, was 98.91%. Conclusions: The IPSOC study, the first to examine adherence to OAD among mRCC pts, shows that mRCC pts are almost fully adherent to treatment recommendations. This seems to be in contrast to adherence data for other, long-lasting, anti-cancer treatments. Further investigations will focus on the question whether extensive counseling and participation in side-effect programs contribute to the high percentage of adherence in this study.

Improving Adherence to Oral Cancer Therapy in Clinical Practice

“…In a prospective study in patients with metastatic renal cell cancer, all patients starting on sunitinib, pazopanib, everolimus, or sorafenib were evaluated, and adherence was measured via questionnaire and MEMS. 58 Overall, 92% of patients claimed to be fully adherent. Based on MEMS data, mean adherence was 99%.…”

“…Adherence in patients taking several of the new oral agents for renal cell cancer appears to be high. In a prospective study in patients with metastatic renal cell cancer, all patients starting on sunitinib, pazopanib, everolimus, or sorafenib were evaluated, and adherence was measured via questionnaire and MEMS . Overall, 92% of patients claimed to be fully adherent.…”

Identifying homogeneous healthcare use profiles and treatment sequences by combining sequence pattern mining with care trajectory clustering in kidney cancer patients on oral anticancer drugs: A case study

“…27 Third, we observed that the MPR was high in our study sample (90%), in accordance with literature. 28 Even though this measure is used as an indirect estimation of medication adherence (i.e. whether patient took the medications as prescribed), such indicator, derived from electronic database, should be interpreted cautiously outside the context of daily clinical practice, since MPR decrease can be related to TKI high-grade toxicity leading to temporary drug discontinuation, even in the presence of a patient with good medication adherence.…”

Dosing strategies and optimization of targeted therapy in advanced renal cell carcinoma

“…32 In contrast, initial results from the first prospective study to investigate adherence to oral medications specifically among patients with mRCC found that adherence was high in this setting. 33 Medicine event monitoring system (MEMS) data reflected a mean adherence of 98.91%, and patientreported adherence was 92%. Extensive patient counseling and participation in side-effect programs used in this small study might explain these results.…”

“…Extensive patient counseling and participation in side-effect programs used in this small study might explain these results. 33 Techniques for measuring adherence are numerous and can include the following: self-reporting, pill count, MEMS, prescription database analysis, and assessment of serum or urine drug levels. Multiple recommendations for improving adherence exist, including effective AE management; enhanced patient communication; educational intervention to increase understanding of the disease and the risks and benefits involved; and patient participation in decision making.…”