Public Health Department, Institut de Cancérologie de la Loire, Saint Priest en Jarez, France.
Eur J Cancer Care (Engl). 2011 Jul;20(4):520-7. doi: 10.1111/j.1365-2354.2010.01212.x. Epub 2010 Jul 23.
Oral chemotherapy is increasingly used in oncology. Poor adherence, that is, non-respect of medical advice about taking the therapy and surveillance of adverse effects, is the main risk associated with this administration route. Poor adherence may be explained by non-adherence by the patient to the treatment, misunderstanding the advice or it could also reflect the poor adaptation of the healthcare team to a new administration route. Here we report the results from a qualitative study that aimed to describe and understand existing practice for capecitabine, an oral chemotherapy, which is used for the treatment of metastatic breast and colon cancer. We interviewed 42 patients who were receiving oral capecitabine in groups and individually as well as 10 prescribers. This study was carried out in two specialist cancer centres. The results showed a wide diversity in the prescribers' practices, who make decisions based on their experience of practice guidelines for intravenous chemotherapies. Although the results for the patients do not suggest deliberate non-adherence, they show poor observance of the dose schedule. The most important result of this study is the patient's inability to identify and to report important signs of harmful toxicity.
口服化疗在肿瘤学中越来越多地被应用。不良的依从性，即不遵守关于服用治疗药物和监测不良反应的医学建议，是与这种给药途径相关的主要风险。不良的依从性可能是由于患者不遵守治疗、误解建议，也可能反映出医疗团队对新的给药途径适应不良。在这里，我们报告了一项定性研究的结果，该研究旨在描述和理解卡培他滨（一种用于治疗转移性乳腺癌和结肠癌的口服化疗药物）的现有实践情况。我们对 42 名接受口服卡培他滨治疗的患者进行了分组和个别访谈，同时还对 10 名开处方者进行了访谈。这项研究在两个专业癌症中心进行。研究结果显示，开处方者的做法存在很大差异，他们根据静脉化疗实践指南的经验做出决定。尽管患者的结果并未表明存在故意不遵医嘱的情况，但他们确实存在不遵守剂量方案的情况。这项研究最重要的结果是患者无法识别和报告严重毒性的重要迹象。
