Adherence to oral anti-cancer therapies in older patients is similar to that of younger patients

J Oncol Pharm Pract. 2023 Jul;29(5):1154-1162. doi: 10.1177/10781552221103547. Epub 2022 May 29.

Abstract

Introduction: The use of oral anti-cancer therapies is becoming increasingly common in the management of cancers, raising the question of adherence. The objective of this study was to assess adherence to oral anti-cancer therapies, as well as the impact of various factors that may influence it.

Methods: Patients starting oral chemotherapy (tyrosine kinase inhibitor or cytotoxic) were followed up for 3 months using a medication diary, which was given to the patient by the pharmacist during a multidisciplinary consultation. Adherence was assessed using the diary, as well as by counting the tablets they brought back.

Results: One hundred and fifty patients were included in the study. The main oral chemotherapy agents prescribed were palbociclib (23.3%), everolimus (18.7%), and capecitabine (13.3%). The adherence at the end of the 3 months, by means of dose intensity (i.e. percent of the dose prescribed that has been taken), was 95.5%. No significant difference in adherence was found based on age, sex, family circumstances, health status, co-medication, type of oral therapy, tumor location, number of previous treatment lines, or presence of toxicity. The main reasons for non-adherence were forgetting (50%) and toxicity (21%). Fifty-seven patients prematurely discontinued the study: 40.3% for toxicity and 36.8% for disease progression.

Conclusion: Adherence in this study is high in comparison to literature, which can be explained by close multidisciplinary follow-up. Moreover, no significant difference was observed between younger and older patients.

Keywords: Adherence; cytotoxic; oral anti-cancer therapy; pharmaceutical consultation; tyrosine kinase inhibitor.

MeSH terms

  • Aged
  • Antineoplastic Agents* / therapeutic use
  • Capecitabine / therapeutic use
  • Humans
  • Medication Adherence
  • Mouth Neoplasms* / drug therapy
  • Protein Kinase Inhibitors

Substances

  • Antineoplastic Agents
  • Capecitabine
  • Protein Kinase Inhibitors