For
this study 30 patients with colorectal and breast cancer who are using
capecitabine were included. The patients were asked to bring any medication
left at the time of scheduled visits. Questionnaire was given at the first
visit and 8-12 weeks after the treatment. It was found that no absolute
adherence to oral capecitabine treatment, but the level of adherence was
somewhat good. They had concluded that the need of a greater focus in the
monitoring the involvement of patient with oral treatment (Figueiredo et
al, 2014).

 

An
observational multicenter study was carried out including 216 patients.
Anti-cancer drug usage and adherence was assessed by means of a telephonic pill
count, a questionnaire, a review of the patient’s medical file and pharmacy
medication records. While majority of the population showed good adherence,
other patients showed both under and over adherence. It was found that majority
of non-adherent patients appear due to experienced side effects. Optimal
adherence was shown by patients who are not living alone and being highly
educated. Interventions should be taken to improve the adherence of non-adherent
patients (Timmers et al, 2014).

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Patients
who are suffering from breast or colorectal cancer and taking capecitabine were
recruited from UK teaching hospital. Non adherence was reported by 23.3% of the
43 participants. Capecitabine adherence was high with a strong conviction that
the therapy is needed. It was found that further interventions should be taken
to improve the adherence of the patients (Bhattacharya et al,
2012).

 

Qualitative
study was carried out to explore processes and factors influencing non
adherence and their relatedness in patients taking oral tyrosine kinase. 30
patients of different ages and with different types of cancers were
interviewed. Treatment related side effects, hopes, anxiety, trust, and
feedback mechanisms were used to determine the adherence. It was observed that
certain processes and factors influenced non adherence. It was concluded that
open climate and a trust-based relationship should be established in patients which
feel comfortable to openly discuss the therapy related difficulties (Verbrugghe
et al, 2016).

 

Another
study had done with 21 chronic myeloid leukemia patients who were prescribed
with Imitanib. In depth interviews were carried out and their adherence had
been previously measured using a medication events monitoring device. It was
found that both intentional and unintentional reasons affect for non-adherence.
Finding ways to deal with side effects and using prompts as reminders to take
medications were observed as favorable factors that improves adherence. It was
suggested that interventions should be designed to ensure that patients with
chronic myeloid leukemia adhere well to their oral drug regimens (Eliasson et
al, 2011).

 

It
was observed that the necessity of health care providers to adapt with practice
changes aimed at supporting patients and optimizing adherence. To minimize
barriers and enhance facilitators to oral treatment adherence, making model or personal
systems were used as potential mechanisms. It was suggested that additional
research is needed to understand what works for patients and how health care
providers can change systems and strategies to support patients to achieve
optimal adherence (Fennimore LA et al, 2017).

 

According
to the current screened literature numerous types of interventions were
investigated to evaluate the factors that affect medication in out-patients as
well as steps that can be applied to overcome barriers to the adherence to oral
medications. Lack of patient education, belief of the patient regarding the
cure, serious nature of the side effects, cost of the medication had become
major factors that affect adherence. Therefore barriers that affect adherence had
to be identified first and necessary solutions must be implemented.