AlignMap

The Presentation

Compliance With Capecitabine Therapy Very High Among Swiss Cancer Patients: Presented at ASCO-GI ¹  summarizes a presentation of study results² made on January 17 at the American Society of Clinical Oncology’s 6th Gastrointestinal Cancers Symposium (ASCO-GI), cosponsored by the American Gastrointestinal Association Foundation, the American Society for Radiation Oncology, and the Society of Surgical Oncology.

The findings are encouraging – but there is a caveat. Pertinent excerpts follow:

Patients who were prescribed oral capecitabine for treatment of breast or gastrointestinal (GI) cancer appear to be highly compliant in taking the oral medication, according to a study conducted in Switzerland.

… For the study, patients receiving capecitabine either as monotherapy or in combination with other chemotherapeutic agents recorded their daily capecitabine intake and any adverse effects on a diary. After completion of therapy for a maximum of 8 cycles, the data were transferred to a questionnaire in which the reasons for discontinuation were also collected.

…  Of the overall cohort, 91% took capecitabine as prescribed for the entire course of treatment. Reasons for interrupting therapy included forgetting to take treatment (56%), adverse effects (25%), and misunderstanding instructions (19%).

… Dr. Winterhalder said that the 16 patients who did make compliance errors included 9 instances in which the patients forgot to take the medicine. He said that despite the impressive compliance figures seen in the study, there are ways to improve the compliance further.

“Patient management systems such as patient diaries may further improve compliance and adherence with treatment,” he said during his poster presentation. “Compliance may be further improved by educating patients about how to recognise and manage treatment toxicities.”

Commentary Or What’s Wrong With This Premise?

Maybe I’m missing something, but I think this study declares that using a medication diary enhances compliance – based on compliance rates measured by the patients’ entries in a medication diary.

And, as far as I can determine, there is no control group for comparison.

Either the summary of this study is incomplete or the quality of the evidence must be considered suspect.

1. Compliance With Capecitabine Therapy Very High Among Swiss Cancer Patients: Presented at ASCO-GI By Ed Susman. Doctor’s Guide. January 19, 2009↩
2. Presentation title: Compliance With Capecitabine: Findings From a Prospective Cohort Analysis. Abstract 420↩