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Lory P, Perche L, Blanc J, Fouquier B, Giroux A, Thomassin A, Devaux M, Renaudin A, Di Martino C, Quipourt V, Bengrine-Lefèvre L, Schmitt A. Adherence to oral anti-cancer therapies in older patients is similar to that of younger patients. J Oncol Pharm Pract 2022:10781552221103547. [DOI: 10.1177/10781552221103547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction The use of oral anti-cancer therapies is becoming increasingly common in the management of cancers, raising the question of adherence. The objective of this study was to assess adherence to oral anti-cancer therapies, as well as the impact of various factors that may influence it. Methods Patients starting oral chemotherapy (tyrosine kinase inhibitor or cytotoxic) were followed up for 3 months using a medication diary, which was given to the patient by the pharmacist during a multidisciplinary consultation. Adherence was assessed using the diary, as well as by counting the tablets they brought back. Results One hundred and fifty patients were included in the study. The main oral chemotherapy agents prescribed were palbociclib (23.3%), everolimus (18.7%), and capecitabine (13.3%). The adherence at the end of the 3 months, by means of dose intensity (i.e. percent of the dose prescribed that has been taken), was 95.5%. No significant difference in adherence was found based on age, sex, family circumstances, health status, co-medication, type of oral therapy, tumor location, number of previous treatment lines, or presence of toxicity. The main reasons for non-adherence were forgetting (50%) and toxicity (21%). Fifty-seven patients prematurely discontinued the study: 40.3% for toxicity and 36.8% for disease progression. Conclusion Adherence in this study is high in comparison to literature, which can be explained by close multidisciplinary follow-up. Moreover, no significant difference was observed between younger and older patients.
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Affiliation(s)
- Pauline Lory
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Louise Perche
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Julie Blanc
- Biostatistics and Data Management Unit, Centre Georges-François Leclerc, Dijon, France
| | - Bastian Fouquier
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Audrey Giroux
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Amélie Thomassin
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Madeline Devaux
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Amélie Renaudin
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Cyril Di Martino
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
| | - Valérie Quipourt
- Department of Geriatrics and Internal Medicine, Hospital of Champmaillot, University Hospital, Dijon, France
- Geriatric Oncology Coordination Unit in Burgundy, University Hospital, Dijon, France
| | | | - Antonin Schmitt
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France
- INSERM U1231, University of Burgundy, Dijon, France
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Mamguem Kamga A, Di Martino C, Anota A, Paget-Bailly S, Coutant C, Arveux P, Desmoulins I, Dabakuyo-Yonli TS. Impact of routine assessment of health-related quality of life coupled with therapeutic information on compliance with endocrine therapy in patients with non-metastatic breast cancer: protocol for a randomized controlled trial. Trials 2020; 21:527. [PMID: 32546198 PMCID: PMC7296931 DOI: 10.1186/s13063-020-04397-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/08/2020] [Indexed: 01/02/2023] Open
Abstract
Background Despite its proven efficacy in reducing recurrence and improving survival, adherence to endocrine therapy (ET) is suboptimal in women with breast cancer (BC). Health-related quality of life (HRQoL) in BC has been widely studied and many positive effects have been highlighted. Recently, a link between HRQoL and compliance with ET has been suggested, which would suggest a potential role for HRQoL assessment in improving compliance with ET. With the advent of digital technologies, electronic collection of HRQoL on a tablet is now possible. Thus, we hypothesize that systematic HRQoL assessment (using a tablet, prior to each consultation, with presentation of scores to clinicians) coupled with therapeutic information could have an impact on 12-month compliance with ET in patients with non-metastatic BC. Methods In this study, we will include 342 women with non-metastatic hormone receptor–positive BC with an indication for treatment with ET. Patients will be randomly assigned 1:1 by minimization and stratified by age, stage, type of ET prescribed, and presence of comorbidities (or not) in two arms. The intervention will consist of numerical HRQoL assessment using the CHES (Computer-based Health Evaluation System) software before each consultation (with delivery of scores to clinicians) coupled with therapeutic information. Therapeutic information will consist of three workshops related to understanding the prescription, nutrition, and fatigue. A reminder letter will be sent to patients every month. Patients in the control group will follow standard care. HRQoL will be assessed using a classic “paper-pencil” collection at baseline in both arms to ensure comparability between arms and at 12 months. The primary endpoint is 12-month compliance with ET. Patient satisfaction with care and the clinicians’ perception of the usefulness of routine HRQoL assessment will also be assessed. Discussion This study will allow clinicians to identify and better understand the areas in which patients who receive ET have difficulties and thus it will assist clinicians with patient management. Systematic evaluation of HRQoL could provide an additional endpoint for measuring patients’ health status and treatment-related symptoms, including ET. If the results of this study are positive, this intervention could be proposed as an integral part of daily clinical practice in patients who receive ET. Trial registration ClinicalTrials.govNCT04176809. Registered Nov. 25, 2019.
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Affiliation(s)
- Ariane Mamguem Kamga
- Epidemiology and Quality of Life Research Unit, INSERM U1231, Georges Francois Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon Cedex, 21000, France
| | - Cyril Di Martino
- Georges François Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Amelie Anota
- Methodological and Quality of Life Unit in Oncology, University Hospital Of Besançon, 3 Boulevard Alexandre Fleming, Besançon, 25000, France.,INSERM, EFS BFC, UMR1098, Interaction Hôte-Greffon-Tumeur/Ingénierie Cellulaire ET Génique, University Bourgogne Franche-Comté, 32 Avenue de l'Observatoire, Besançon, 25000, France.,National Quality of Life and Cancer Platform, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Sophie Paget-Bailly
- Methodological and Quality of Life Unit in Oncology, University Hospital Of Besançon, 3 Boulevard Alexandre Fleming, Besançon, 25000, France.,INSERM, EFS BFC, UMR1098, Interaction Hôte-Greffon-Tumeur/Ingénierie Cellulaire ET Génique, University Bourgogne Franche-Comté, 32 Avenue de l'Observatoire, Besançon, 25000, France
| | - Charles Coutant
- Surgery Department, Georges François Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon, 21000, France.,Burgundy Franche-Comté University, 7 Boulevard Jeanne d'Arc, Dijon, 21000, France
| | - Patrick Arveux
- Epidemiology and Quality of Life Research Unit, INSERM U1231, Georges Francois Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon Cedex, 21000, France.,Centre for Research in Epidemiology and Population Health (CESP), INSERM U1018, University Paris-Sud, UVSQ Gustave Roussy, 12 Avenue Paul Vaillant Couturier, Villejuif, 94800, France
| | - Isabelle Desmoulins
- Medical Oncology Unit, Centre Georges-François Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon, 21000, France
| | - Tienhan Sandrine Dabakuyo-Yonli
- Epidemiology and Quality of Life Research Unit, INSERM U1231, Georges Francois Leclerc Centre - UNICANCER, 1 rue du Professeur Marion, Dijon Cedex, 21000, France. .,National Quality of Life and Cancer Platform, 1 rue du Professeur Marion, Dijon, 21000, France.
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