Marina Milic1, Anna Foster1, Karim Rihawi2, Alan Anthoney3, Chris Twelves4. 1. St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK. 2. St James's Institute of Oncology, Leeds Teaching Hospitals Trust, Leeds, UK; Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy. 3. Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals Trust, Leeds, UK. 4. Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals Trust, Leeds, UK. Electronic address: c.j.twelves@leeds.ac.uk.
Abstract
UNLABELLED: The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored. AIM: We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment. METHODS: One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets. RESULTS: The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience. CONCLUSION: Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC.
UNLABELLED: The implications for patients with cancer, of the 'tablet burden' resulting from increasing use of oral anticancer drugs and medication for co-morbidities have not previously been well explored. AIM: We sought to (i) quantify tablet burden in women with metastatic breast cancer (MBC), (ii) establish which groups of drug contribute most to this burden and (iii) gain insight into patients' attitudes towards oral anti-cancer treatment. METHODS: One hundred patients with MBC anonymously completed a questionnaire describing their medication histories and attitudes towards their tablets. RESULTS: The patients (mean age 60, range 31-95) were all female and taking a median of six tablets (range 0-31) daily; 37 patients were taking >10 tablets. Oral anticancer treatment constituted the category of treatment taken by the highest proportion of patients, followed by symptomatic cancer treatments, proton pump inhibitors and cardiovascular medication. Numerically, however, symptomatic drugs accounted for 44% of all tablets and specific anti-cancer treatment for 15%; medication not directly related to the cancer accounted for the remaining 40% of tablets. A quarter of patients reported inconvenience in taking their tablets, the main reason being tablet size and one third reported forgetting their tablets at least once a week. Nearly two thirds of patients expressing a preference favoured oral anticancer treatment, the commonest reason being greater convenience. CONCLUSION: Tablet burden is considerable for many patients with MBC and can be problematic. A significant proportion of tablets represent treatment for co-morbidities, the significance of which may be questionable in women with MBC.
Authors: Ana Isabel Gonzalez; Christine Schmucker; Joerg J Meerpohl; Christiane Muth; Julia Nothacker; Edith Motschall; Truc Sophia Nguyen; Maria-Sophie Brueckle; Jeanet Blom; Marjan van den Akker; Kristian Röttger; Odette Wegwarth; Tammy Hoffmann; Sharon E Straus; Ferdinand M Gerlach Journal: BMJ Open Date: 2019-12-15 Impact factor: 2.692
Authors: Karen Kaiser; Susan E Yount; Christa E Martens; Kimberly A Webster; Sara Shaunfield; Amy Sparling; John Devin Peipert; David Cella; Scott T Rottinghaus; Bonnie M K Donato; Richard Wells; Ioannis Tomazos Journal: Patient Prefer Adherence Date: 2020-04-05 Impact factor: 2.711