Bhattacharya Debi, Easthall Claire, Willoughby Kerri Anne, Small Matthew, Watson Steven
School of Pharmacy, University of East Anglia, Norfolk, UK.
J Oncol Pharm Pract. 2012 Sep;18(3):333-42. doi: 10.1177/1078155211436022. Epub 2012 Feb 1.
OBJECTIVES: The prescribing of oral chemotherapy agents previously available only in the intravenous formulation, such as capecitabine, has afforded many benefits including reduced administration costs and improved patient acceptability. However, it has introduced the new challenge of ensuring patient adherence to therapy. It is therefore necessary to quantify adherence, and with a view to improving services, explore factors that may impact on medication taking behavior. METHODS: Patients with a diagnosis of breast or colorectal cancer and prescribed capecitabine were recruited from a UK teaching hospital. Data regarding self-reported adherence, beliefs about medicines, side effects, and satisfaction with information received about capecitabine were recorded. RESULTS: Non-adherence was reported by 23.3% of the 43 participants. Capecitabine therapy was perceived necessary by 97.6%, but almost one-third of participants had strong concerns. Side effects were reported by 80% of participants, with Palmar-Plantar erythrodysesthesia and fatigue most troubling participants. Complete satisfaction with information received was reported by 65% of participants; however, dissatisfaction about how to tell if capecitabine is working and the proposed duration of therapy was expressed by 42.9% and 37.3% of participants, respectively. CONCLUSIONS: Adherence to capecitabine is high with a strong conviction that the therapy is necessary. However, concerns were expressed regarding the experience of side effects. Patients have unmet information needs regarding the processes involved with monitoring capecitabine efficacy and determination of therapy duration. Healthcare professionals may therefore wish to consider a greater focus on involving patients in the monitoring of their care with respect to efficacy and planned treatment schedules.
目的:开具以前仅以静脉制剂形式提供的口服化疗药物,如卡培他滨,带来了许多益处,包括降低给药成本和提高患者接受度。然而,这也带来了确保患者坚持治疗的新挑战。因此,有必要对依从性进行量化,并为改善服务探索可能影响用药行为的因素。 方法:从一家英国教学医院招募诊断为乳腺癌或结直肠癌并开具卡培他滨的患者。记录有关自我报告的依从性、对药物的信念、副作用以及对所获得的关于卡培他滨信息的满意度的数据。 结果:43名参与者中有23.3%报告不依从。97.6%的人认为卡培他滨治疗是必要的,但近三分之一的参与者有强烈担忧。80%的参与者报告有副作用,手足红斑感觉异常和疲劳最困扰参与者。65%的参与者报告对所获得的信息完全满意;然而,分别有42.9%和37.3%的参与者对如何判断卡培他滨是否有效以及建议的治疗持续时间表示不满。 结论:对卡培他滨的依从性较高,且坚信该治疗是必要的。然而,对副作用的体验存在担忧。患者在监测卡培他滨疗效和确定治疗持续时间所涉及的过程方面有未满足的信息需求。因此,医疗保健专业人员可能希望考虑更加注重让患者参与对其疗效和计划治疗时间表的护理监测。
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