Adherence to oral chemotherapy: Evidence from a randomised clinical trial

Abstract

Objective To evaluate the efficacy of a reinforcement message (RM) administered by a hospital pharmacist on adherence, through a randomised study involving patients undergoing oral chemotherapy from which an objective outcome measure and patients’ subjective opinions were collected. A secondary aim was to detect which psychological or clinical factors influence adherence. Methods Forty patients were enrolled and randomised to an experimental group (EG) or a control group (CG). The EG received a 10‐minute RM provided by a hospital pharmacist with a doctor and a nurse. The CG received the standard of care. To measure adherence, plasma drug concentration and subjective evaluation were taken during the visits, in addition to a psychological assessment (coping strategies, psychological distress and personality traits). Results The EG reported higher drug levels and a statistically significant higher mean score on the subjective evaluation. A linear regression model highlighted statistically significant differences in the plasma drug concentration, after considering toxicity and dose reduction and controlling for the Reward Dependence Scale of the Temperament and Character Inventory between the EG and the CG. Conclusion Adequate information and education on the therapy, using an RM strategy provided by a hospital pharmacist, seems to positively influence adherence to the treatment.

A smartphone program to support adherence to oral chemotherapy in people with cancer: Proof‐of‐concept trial

“…7 Interventions using multiple strategies to address OC-related side-effects and knowledge are effective in improving adherence to OC (nonendocrine). 6,[8][9][10][11][12][13][14] However, these interventions have not addressed the three main reasons for OC nonadherence using short message service (SMS) technology.…”

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“…In addition, it can cause rapid shock and infection, and the adverse reactions are prompt, critical and difficult to reverse [7]. Oral chemotherapy is simple, painless, and with a good patient compliance [8,9]. Achieve and maintain the required concentration in vivo to obtain a long-term exposure of cancer cells to the drug, maintaining its concentration below the minimum toxic level in the plasma is an important step that may improve the therapeutic effect and reduce the side effects [10,11].…”