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General and Risk Management, Patient Safety (including: medication errors, quality control)
Adherence to capecitabine chemotherapy
  1. T. Gramage Caro,
  2. E. Delgado Silveira,
  3. M.A. Rodríguez Sagrado,
  4. M. Sánchez Cuervo,
  5. I. Cuesta López,
  6. T. Bermejo Vicedo
  1. 1Hospital Ramon y Cajal, Pharmacy, Madrid, Spain


Background Hospital pharmacy departments in Madrid have been required to dispense capecitabine since February 2011 and it represents 38% of prescriptions of oral chemotherapeutics at our hospital. Monitoring adherence may help to prevent treatment failure, avoid adverse effects and reduce the resulting costs.

Purpose The aim of this study was to evaluate adherence to capecitabine.

Materials and methods Prospective observational study, conducted between July and September 2011 in the outpatient unit of a hospital pharmacy department. 30 patients treated with capecitabine, either as monotherapy or in combination with other chemotherapeutic agents, were randomly selected. Each patient was followed up for 2 to 3 months through consecutive interviews. Data recorded: personal details (age, gender, marital status, educational background, occupation), disease variables (tumour type, ECOG performance status, disease onset, concomitant illness), treatment issues (type of treatment, line of chemotherapy, pill burden, duration of treatment, side effects) and drug adherence parameters. A patient was considered to be adherent to treatment if an overall percentage adherence ≥95% was achieved by three indirect methods (dispensing records, pill count and a validated adherence questionnaire (Morinsky–Green test)).

Results 30 patients were included (mean age 65.3 years, 73% men). 50 interviews were conducted (1.7 interviews/patient). Principal medical diagnosis: colon tumours (43%), rectum tumours (27%) and breast cancer (17%). Median pill burden was 9.6 tablets/day (4.8 tablets/dose). Side effects were detected in 26 interviews, 50% of them were hand-foot syndrome. Two patients required dose adjustment as a result. Overall, 28 patients (93%) were considered to be adherent. Two patients (7%) reported some kind of compliance error in one of their interviews. Reasons for non-compliance were forgetting to take treatment and side effects.

Conclusions Adherence to capecitabine in clinical practice is high, despite a high pill burden.

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