Forthis study 30 patients with colorectal and breast cancer who are usingcapecitabine were included.
The patients were asked to bring any medicationleft at the time of scheduled visits. Questionnaire was given at the firstvisit and 8-12 weeks after the treatment. It was found that no absoluteadherence to oral capecitabine treatment, but the level of adherence wassomewhat good. They had concluded that the need of a greater focus in themonitoring the involvement of patient with oral treatment (Figueiredo etal, 2014). Anobservational multicenter study was carried out including 216 patients.Anti-cancer drug usage and adherence was assessed by means of a telephonic pillcount, a questionnaire, a review of the patient’s medical file and pharmacymedication records.
While majority of the population showed good adherence,other patients showed both under and over adherence. It was found that majorityof non-adherent patients appear due to experienced side effects. Optimaladherence was shown by patients who are not living alone and being highlyeducated. Interventions should be taken to improve the adherence of non-adherentpatients (Timmers et al, 2014). Patientswho are suffering from breast or colorectal cancer and taking capecitabine wererecruited from UK teaching hospital. Non adherence was reported by 23.3% of the43 participants.
Capecitabine adherence was high with a strong conviction thatthe therapy is needed. It was found that further interventions should be takento improve the adherence of the patients (Bhattacharya et al,2012). Qualitativestudy was carried out to explore processes and factors influencing nonadherence and their relatedness in patients taking oral tyrosine kinase. 30patients of different ages and with different types of cancers wereinterviewed.
Treatment related side effects, hopes, anxiety, trust, andfeedback mechanisms were used to determine the adherence. It was observed thatcertain processes and factors influenced non adherence. It was concluded thatopen climate and a trust-based relationship should be established in patients whichfeel comfortable to openly discuss the therapy related difficulties (Verbruggheet al, 2016).
Anotherstudy had done with 21 chronic myeloid leukemia patients who were prescribedwith Imitanib. In depth interviews were carried out and their adherence hadbeen previously measured using a medication events monitoring device. It wasfound that both intentional and unintentional reasons affect for non-adherence.Finding ways to deal with side effects and using prompts as reminders to takemedications were observed as favorable factors that improves adherence. It wassuggested that interventions should be designed to ensure that patients withchronic myeloid leukemia adhere well to their oral drug regimens (Eliasson etal, 2011).
Itwas observed that the necessity of health care providers to adapt with practicechanges aimed at supporting patients and optimizing adherence. To minimizebarriers and enhance facilitators to oral treatment adherence, making model or personalsystems were used as potential mechanisms. It was suggested that additionalresearch is needed to understand what works for patients and how health careproviders can change systems and strategies to support patients to achieveoptimal adherence (Fennimore LA et al, 2017). Accordingto the current screened literature numerous types of interventions wereinvestigated to evaluate the factors that affect medication in out-patients aswell as steps that can be applied to overcome barriers to the adherence to oralmedications.
Lack of patient education, belief of the patient regarding thecure, serious nature of the side effects, cost of the medication had becomemajor factors that affect adherence. Therefore barriers that affect adherence hadto be identified first and necessary solutions must be implemented.