Pharmacy Department, Northumbria Healthcare NHS Trust, North Shields, Tyne and Wear, UK.
Int J Clin Pharm. 2014 Apr;36(2):271-3. doi: 10.1007/s11096-014-9921-1. Epub 2014 Feb 15.
A case study of a patient who over complied with adjuvant capecitabine monotherapy on several occasions is described. The patient suffered worsening side effects, predominantly palmar plantar erythrodysesthesia which resulted in dose reduction and delay. The patient had disregarded advice to stop taking the capecitabine as he perceived it as "important to fight his cancer". The patient refused review with a psychologist.
There is a lack of evidence regarding the issue of over compliance. Pharmacists should consider discussing patient's attitudes towards taking their medication and its importance to them in treating their cancer. Tools that are used to assess non-compliance could be utilised to identify patients who over comply. Further research is required to gain further understanding of the psychological factors behind patient's decisions to over comply with treatment.
本文描述了一位患者多次过度依从卡培他滨辅助单药治疗的病例研究。该患者出现了更严重的副作用,主要是手掌-足底红斑感觉异常,导致剂量减少和延迟。尽管患者已被告知停止服用卡培他滨,但他仍无视该建议,因为他认为这对“抗击癌症很重要”。该患者拒绝与心理学家会诊。
目前关于过度依从性的问题还缺乏证据。药剂师应考虑讨论患者对服用药物的态度及其对治疗癌症的重要性。可利用评估不依从性的工具来识别过度依从治疗的患者。需要进一步研究以更深入地了解患者过度依从治疗决策背后的心理因素。