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Improvement in adherence to Capecitabine and Lapatinib by way of a therapeutic education program

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Abstract

Purpose

A patient non-adherence with oral anticancer agents is a well-recognized barrier to effective treatment. The aim of this prospective study was to evaluate the efficacy of a therapeutic education program among non-adherent patients treated with Capecitabine alone or associated with Lapatinib.

Methods

Sixty-five cancer patients were enrolled. Among them, 55 participated in the first observational phase of the study, measuring adherence using electronic MEMS pillboxes (medication event monitoring system). An adherence score was assessed in the form of a composite adherence score including intake dose and intake intervals. Ten non-adherent patients (adherence score < 80%) were included in the intervention phase of the study and were enrolled on a therapeutic education program. The efficacy of the program was evaluated on the basis of an improvement in adherence scores. We also studied factors influencing adherence.

Results

The average adherence score was 83.6 ± 15.7% in the overall population. Forty-one patients were adherent (adherence score > 80%) and 14 patients were non-adherent (adherence score < 80%). The therapeutic education program for non-adherent patients (n = 10) increased their adherence score by 17.8% and led 60% of these patients to become adherent. The number of toxicities during the first cycles was a predictive factor for non-adherence.

Conclusion

This study showed an improvement in adherence to Capecitabine ± Lapatinib among non-adherent patients by way of a therapeutic education program.

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Acknowledgments

The authors thank the Centre Jean Perrin for making this study possible.

Author information

Authors and Affiliations

  1. Oncology Department, Centre Jean Perrin, F-63011, Clermont-Ferrand, France

    Laure Vacher, Camille Poirier, Marie-Ange Mouret-Reynier, Philippe Chollet, Hervé Devaud, Pascale Dubray-Longeras, Xavier Durando & Isabelle van Praagh-Doreau

  2. University Clermont 1, UFR Médecine, FR-63000, Clermont-Ferrand, France

    Laure Vacher & Xavier Durando

  3. Délégation Recherche Clinique & Innovation, Centre de Lutte contre le Cancer, 58 rue Montalembert, F-63000, Clermont-Ferrand, France

    Emilie Thivat, Philippe Chollet, Fabrice Kwiatkowski & Xavier Durando

  4. Centre d’Investigation Clinique UMR 501, F-63001, Clermont-Ferrand, France

    Emilie Thivat, Philippe Chollet, Fabrice Kwiatkowski & Xavier Durando

  5. Université Clermont Auvergne, Centre Jean Perrin, INSERM, UMR1240 Imagerie Moléculaire et Stratégies Théranostiques, FR-63000, Clermont-Ferrand, France

    Emilie Thivat, Marie-Ange Mouret-Reynier, Pascale Dubray-Longeras, Xavier Durando & Isabelle van Praagh-Doreau

  6. Pharmacy Department, Centre Jean Perrin, F-63011, Clermont-Ferrand, France

    Régine Chevrier

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  1. Laure Vacher
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Contributions

ET and FK participated in the design of the study. CP, MAMR, PC, HD, PDL, XD, RC, IVP, ET, and FK were involved in the data collection, analysis, and interpretation. LV and ET drafted the manuscript. All authors were involved in the critical revision of the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Laure Vacher.

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Conflict of interest

The authors declare that they have no competing interests. The data cannot be made publically available according to French regulations and laws.

Ethical approval

The study protocol was approved by the Ethics Committee (French sud-EST VI Ethics Committee) and met the recommendations stated in Helsinki Declaration.

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All the patients signed informed consent.

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Vacher, L., Thivat, E., Poirier, C. et al. Improvement in adherence to Capecitabine and Lapatinib by way of a therapeutic education program. Support Care Cancer 28, 3313–3322 (2020). https://doi.org/10.1007/s00520-019-05144-x

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