Adverse reactions and adherence to capecitabine: A prospective study in patients with gastrointestinal cancer

Abstract

Introduction Capecitabine is an oral anticancer drug which can cause some adverse reactions and the great challenge for its use is to ensure the medication adherence. The aim of this study was to analyze adverse reactions and adherence to capecitabine in patients with gastrointestinal cancer. Methods A prospective study was performed in a tertiary teaching hospital in Brazil. Outpatients undergoing capecitabine treatment for colorectal or gastric cancer were followed for three cycles of treatment. Patient demographic and clinical characteristics data were collected. Adverse reactions were analyzed using Common Terminology Criteria for Adverse Events (CTCAE) v.4. Adherence to capecitabine were evaluated using Morisky-Green and MedTake tests. Statistical analysis was conducted using Chi‐square, Fisher's exact and McNemer tests. Results One hundred and four patients were enrolled in this study, with a mean age was 58.5 ± 10.9 years; 51.0% were men and 51.0% Caucasian. Nausea and diarrhea were the most frequently reported adverse reactions (82.7% and 62.5%, respectively), followed by vomiting (54.8%), fatigue (54.8%), and hand-foot syndrome (53.9%). Nausea and diarrhea were also the most severe adverse reactions. Most patients were adherent to capecitabine in all cycles of treatment using the Morisky-Green test. Adherence increased significantly between cycle 1 and cycle 2 by MedTake test (p < 0.001). Some demographic and clinical characteristics were associated with adverse reactions (e.g., age and nausea, gender and nausea and vomiting) and capecitabine adherence (e.g., marital status and educational level) as well as some adverse reactions were associated with capecitabine adherence (hand-foot syndrome and nausea). Conclusions Clinical oncology pharmacists must provide patient information on the correct use of capecitabine, manage adverse reactions, and monitor adherence to treatment. Strategies to prevent non-adherence to capecitabine must be adopted to ensure the success of pharmacotherapy.

Study on Huangqi Bazhen Decoction on Relieving Chemotherapy Intestinal Mucositis in Capecitabine Gavage Mice

“…Chemotherapy-induced intestinal mucositis brings great pain to patients, reduces chemotherapy compliance, and hinders clinical work. Generally, patients can relieve symptoms by reducing the dose of chemotherapy, but it will seriously affect the progress of tumor treatment [5]. Traditional Chinese medicine (TCM) plays an important role in the treatment and recovery of gastroenteritis with its unique diagnosis, treatment methods, and concepts [6].…”

Role of clinical pharmacist in the palliative care of adults and elderly patients with cancer: A scoping review

“…After having highlighted the role of the clinical pharmacist in specific fields such as onco-hematology and bone marrow transplant, 29 pediatric hematology-oncology, 30 and providing patient counselling for patients with gastrointestinal cancer receiving oral anticancer treatment (capecitabine), 31 we discussed another specific field in this paper which is palliative care for patients with cancer. This scoping review identified 14 relevant studies on the activities and-or services provided by clinical pharmacists in the palliative care of adults and elderly patients with cancer.…”

Patients' Adherence to Capecitabine Treatment Is Affected by The Drug-Related Adverse Effects Rather Than by Their Sociodemographic Characteristics

“…The suggested protective effects of estrogens and progestins, the exposure to risk factors in diet and lifestyle, such as alcohol and smoking, as well as the observation that men over the age of 50 are less likely to seek medical advice or to participate in screening programs, all these reasons might explain the higher prevalence of CRC among males aged more than 50 years than their age-matched females 21,22 .…”